A BSTRACT Background: As the proportion of elderly in the population increases, they also become vulnerable to various types of intentional or unintentional injuries. Domestic accidents including falls among the elderly have been identified as a leading cause of injury-related morbidity and mortality in India and elsewhere. Aim: This study aims to assess the burden and pattern of domestic accidents in a rural part of Southern India. Methods and Setting: A community-based cross-sectional study among the elderly (≥60 years) was carried out in rural areas of Southern Karnataka. A semi-structured interview schedule was used to get the information on domestic accidents. Inferential statistical tests like the Chi-square test and logistic regression analysis were used. Results: A total of 500 persons aged ≥60 years with a mean age of 69.09 ± 7.42 years (Range 60–92 years) were included. One-third of the subjects have had an incidence of domestic accidents in the past 1 year contributing to a 35% prevalence of domestic accidents. A higher prevalence of domestic accidents was seen in those subjects who were ill (47.9%). Overall prevalence of falls was 21.4% ( P = 0.007). One-fifth of the subjects with domestic accidents had a residual illness. Conclusion and Contribution: One-third of our subjects gave a history of one or the other form of domestic accidents in the previous 1 year. Our study highlights the problem of unintentional domestic injuries among the most vulnerable group of the elderly and calls for a continuous assessment of the burden and nature of injuries.