Background: COVID-19 is a novel and highly contagious disease that has worse and serious side effects among all age groups, but elderly are the most affected. COVID-19 increases the risk of elderly for hospitalization and dying, as the elderly has multiple chronic condition and low immunity. Thus, compliance with preventive behaviors is very essential to save elderly life. Aim of the study: to determine compliance of elderly with preventive behaviors regarding COVID-19 at rural areas in El Gharbia Governorate. Subjects and method: Study design: A descriptive cross sectional research design was utilized in this study. Setting: This study was conducted at rural villages in El Gharbia Governorate at Bolkina, Shndalat and Elgaafaria rural villages through home visits. Study subjects: A convenience sample of 400 elderly was utilized in this study. Tools: One tool was used to collect the necessary data. It consisted of three parts as follows: Part (1): Socio-demographic characteristics of rural elderly people and health history. Part (2): Knowledge of rural elderly about COVID 19.Part (3): Reported practices of rural elderly regarding preventive behaviors of COVID 19. Results: It was found that, nearly one third (30%) of the studied elderly had poor knowledge regarding COVID 19. Also, most of them (70%) had unsatisfactory practice score. There was significant positive correlation between total knowledge score and total practice score of the studied elderly. Conclusion and recommendations:Based on our study findings, we can conclude that, compliance of most rural elderly regarding preventive behaviors of COVID 19 is unsatisfactory and need improvement. So, we can recommend that: health education programs about preventive behaviors of COVID-19 should be conducted for elderly in rural areas.