Background : Global ageing population is in increasing trend. Morbidity increases with age and enhances the burden of health problems that results in new challenges to meet the additional demands. There can be various types of issues such as health problems, health care utilization, physical and social care which should be carefully assessed and addressed.Objective : This study aimed to assess the unmet health care needs among elderly.Methodology : A Community based, House to House, Cross sectional study was conducted in urban areas of sunsari district using face to face interview. Sample size of 530 elderly were selected by Systematic proportionate random sampling technique.Results : This study unfurled the prevalence of unmet need for consultation for Near vision 52.3%, Far vision 53.7%%, Hearing 79.7%, Dental 79.4%, Hypertension 6.7%, Diabetes 3.9%, CVD 5.3 %, and of at least one Unmet Health care need to be 64.9%. At least one unmet health need was significantly associated with higher odds among elderly of age more than 70, of dalit and janajati ethnicity, illiterate, poor, those with difficulty leaving home, distance of health facility > 30 mins, and those with depressive symptoms.Conclusion : The study highlighted higher prevalence and associated factors related to unmet health care needs among elderly. There is an urgent need to promote geriatric health services and make it available at the primary health care level.