Background: Type 2 diabetes (DM) mellitus and Hypertension (HT) are among the most common chronic non-communicable diseases affecting at a higher prevalence in the older age group. The presence of hypertension in diabetic patients substantially increases the risks of coronary heart disease, stroke, nephropathy and retinopathy. The objective of this study is to determine the prevalence rate and risk factor associated with co-existence of hypertension and diabetes mellitus in elderly population in Arar city, Northern Saudi Arabia. Methods: A cross sectional study, included 181 elderly attending seven randomly selected primary healthcare centers in Arar city during the period from 1^st January to 30^th June 2017. Participants selected using a systemic random sampling procedure as we take every second elderly attending the PHC during the study period. Data collected by means of personal interview using a predesigned questionnaire covering the required items. Results: The prevalence of coexistence of diabetes and hypertension was 16.6% while coexistence of diabetes, hypertension and obesity were found in 9.9%. Two-thirds (66.66%) of cases of coexisting diabetes and hypertension were females (P value>0.05). The relation between coexisting diabetes and hypertension with smoking status was significant (P value<0.05) while the relation with BMI was non-significant (P value>0.05). Conclusion: Coexistence of diabetes and hypertension were found in 16.6% of elderly population of Arar, Northern KSA. This association leads to several cardiovascular complications, so it is mandatory to adopt more strategies for the control of DM and HT in Arar elderly population by appropriate methods.