This study examines the rural-urban differences in depression among older adults with multiple chronic conditions in India, using data from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017-18). The prevalence of depression was 9.48% higher in rural areas (38.33%) compared to urban areas (28.85%). Key factors contributing to these differences include education, caste status, disability in activities of daily living (ADL), perceived discrimination, and self-rated health. The study highlights the need for targeted interventions to address the unique challenges faced by older patients in rural areas, such as lack of social capital, discrimination, and limited access to healthcare services. The findings underscore the importance of collaborative efforts between policymakers and healthcare professionals to improve mental health and overall well-being for rural older adults, especially those with multiple comorbidities.This study examines the rural-urban differences in depression among older adults with multiple chronic conditions in India, using data from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017-18). The prevalence of depression was 9.48% higher in rural areas (38.33%) compared to urban areas (28.85%). Key factors contributing to these differences include education, caste status, disability in activities of daily living (ADL), perceived discrimination, and self-rated health. The study highlights the need for targeted interventions to address the unique challenges faced by older patients in rural areas, such as lack of social capital, discrimination, and limited access to healthcare services. The findings underscore the importance of collaborative efforts between policymakers and healthcare professionals to improve mental health and overall well-being for rural older adults, especially those with multiple comorbidities.