Our aim in this study is to assess the prevalence of abuse in elders with psychiatric illness and its association with various sociodemographic variables. Methods This cross-sectional comparative study included 300 elderly (aged more than 65 years) patients divided into two groups. Group 1 consisted of 150 patients with psychiatric illnesses presenting to the psychiatry outpatient department (OPD), whereas group 2 comprised 150 patients with somatic illnesses presenting to the OPDs of other departments. Elder Abuse Suspicion Index (EASI) was used as a screening tool for the detection of elder abuse. In patients with suspicion of abuse on EASI, the Actual Abuse Tool was used for confirmation and assessment. Results A significantly higher prevalence of abuse was seen in elders with psychiatric illness (21.3%) compared to those with somatic illness (4%). Among sociodemographic variables, a significant correlation was found between elder abuse and gender, literacy, and marital status. Conclusions Elder abuse is a serious social problem. Awareness should be raised to improve the attitude and behavior towards seniors. Healthcare professionals, especially in the psychiatry field, should be made more capable of and open towards early detection of and intervention against elder abuse. Further research on this topic in India is highly recommended.