Fall is one of the serious health issues among elderly population in Malaysia. In the event of a fall, a strong impact may be inflicted on the elderly causing severe injuries or even death. Another research by the National Institutes of Health found that 67% of elderly who fall and fail to seek help within 72 hours are unlikely to survive. Current Personal Emergency Respond System (PERS) often employs the use of a manual emergency button. However this approach may not be useful if the fall victim become unconscious or even not be able to move to reach the emergency button. In addition, such as this approach also requires more time and inadequate to notify and seek for immediate help. This paper attempts to design and implement a smart fall detection system for real time notification known as e-SAFE. This system will automatically detect a fall and notifies the incident instantly to internal and external correspondence. The e-SAFE equipped with a wearable accelerometer sensor, microcontroller, ZigBee transceiver module and Global System for Mobile communications (GSM) device. The in-house correspondence will be notifies though the ZigBee technology, meanwhile the external correspondence will be notified through GSM. Once a fall has been detected by e-SAFE system, a Short Message Service (SMS) and an E-mail will be sent to predefined contacts which is stored in the system. This system will provide a path toward independent living for the elderly while keeping them save.