Globally, countries are experiencing significant shifts in population age structures due to increased life expectancy and lower fertility rates. In the last five decades, the elderly population has risen from 31 million to 106 million and from 0.6 million to 2.3 million in Kenya and India respectively. Both countries are facing an epidemiological transition, with non-communicable diseases (NCD) posing major health concern for the elderly. Despite prioritizing the control of communicable diseases, non-communicable diseases (NCDs) are placing a significant strain on the limited health and social security resources in both nations. This study utilized published data to compare NCDs among the elderly populations in Kenya and India. The findings from the trend analysis showed that in India NCDs accounted for 60% of elderly health issues, followed by disabilities (30%) and mental health (10%). In Kenya, NCDs accounted for 65% of elderly issues, disabilities 23% and mental health 12%. Cardiovascular diseases and hypertension were the leading NCDs in both countries. The elderly spent 47% and 45% of their resources on NCD treatment in Kenya and India respectively. Common risk factors, including tobacco and alcohol use, physical inactivity, and unhealthy diets, were widespread. Men were found to be more vulnerable to NCDs than women and the prevalence of multimorbidity increased with age. Access to insurance and social security differed, with India having more government-sponsored insurance than Kenya. The study concluded that urgent healthcare interventions were needed in both countries to address NCDs among the elderly at policy and program levels, ensuring integrated care for this vulnerable population.