Objective To assess the association between municipality altitude and quality of life (QOL) of older people in Colombia. Methods Cross-sectional study with data from the Colombian Demographic and Health Survey Older Adult Questionnaire 2015 ( N = 13,970). QOL was measured in six domains: physical health, psychological health, functional status, social relations, medical history and economic status. Regression analyses were carried out adjusting by individual and contextual level variables. Results Low altitude was associated with better QOL: physical health (OR = 1.92, 95%CI 1.47−2.52), psychological health (OR = 1.59, 95%CI 1.26−2.00), functional status (OR=1.80, 95%CI 1.45−2.23), social relations (OR = 2.16 95%CI 1.73−2.70), and medical history (OR = 1.57, 95%CI 1.37−1.81). Economic status was not associated with altitude. Discussion Living at high altitude was associated with lower QOL for Colombian older adults. This finding encourages further study of high altitude and health outcomes among older adults in Colombia and other countries with populations living at high altitudes.