Background: Virtual Reality (VR) has shown promise in healthcare, especially in areas like cognitive training, pain management, and motor rehabilitation, yet adapting it for use among elderly individuals comes with specific limitations and barriers. Aims and Objectives: This study analyses the challenges and practical considerations in applying Virtual Reality (VR) to Tamil geriatric patients during physiotherapy management. Materials and Methods: This qualitative study, utilized in-depth interactive interviews through a Semi-structured interview to collect and analyse data. Participants 34 native Tamil geriatric patients aged more than 60 years (67.5 ±2.78) complaining of a painful restricted range of motion in the unilateral shoulder joint diagnosed as periarthritis shoulder were treated with fully immersive virtual reality technology for 7 days. Following the intervention, the patients were interviewed under 5 codes (“usability,” “comfort,” “satisfaction,” “technical issues,” and “practical consideration”) Results: Participants reported virtual reality was enjoyable and engaging, a positive impact and motivation. Dizziness and sweating during virtual reality sessions when it extended beyond 20 minutes was a concern. Several participants faced hardware problems, such as issues with headset fit, leading to discomfort and difficulties in using hand-held control buttons. Adjusting virtual reality settings, including boundaries and game-level setting, was mentioned as a practical challenge for some participants. Conclusion: Proper orientation, patient selection for virtual reality, and sufficient familiarization are essential for the success of virtual reality rehabilitation among the Tamil geriatric population