Background: Anemia is a common, multifactorial condition in the elderly; it is prevalence increases with age which adversely affects older adult's general health and physical activity. Rural elderly are more prone to becoming anemic due to lack of medical facilities and poor economic conditions. The aim of this study was to investigate the association between anemia and physical activity among elderly in rural areas, Sharkia governorate. Design: A cross-sectional descriptive design was utilized in the study. Setting: The study was conducted at Sharkiat Mobasher Village, Elibrahemya District, Sharkia Governorate. Sample: A systematic random sampling technique of 150 elderly, then anemic elderly were selected and given the nutritional guidelines. Tools: Four tools were used to collect the study data: I) A structured interview sheet. II) The Mini Nutritional Assessment short form (MNA). III) Assessment of elderly's activity level [Katz scale for activities of daily life (ADLs) & International Physical Activity Questionnaire (IPAQ) short form]. IV) Laboratory investigations [complete blood count (CBC) & stool analysis]. Results: The study results revealed that the prevalence of anemia among the studied elderly was 36.7%. The anemic elderly had poorer physical activity level and more disability in activities of daily living than non-anemic elderly. Conclusion: Anemia representing an important health problem among older individuals and had an adverse effect on the elderly's physical activity. Recommendation: Health education programs to increase the elderly awareness about the importance of periodic medical check-up and healthy life habits.