Objectives: The purpose of this study is to investigate the relationship between health promotion behaviors and chronic disease prevalence of Korean elderly and to provide information for preventing chronic diseases and improving health conditions of the elderly. Methods: A subset of 584 cases in the fourth Korea National Health and Nutrition Examination Survey was used for secondary analysis. Chi square test was used to compare chronic diseases prevalence by general characteristics and health promotion behaviors. Logistic regression analysis was used to identify the factors associated with chronic diseases. Results: Gender, occupation, subjective health status, smoking, and alcohol drinking have significant association with chronic diseases. Conclusions: Gender-specific health education for the elderly should be implemented at the health center, and opportunities for social participation can be enhanced through job creation for the elderly. Active campaigns on smoking cessation and moderate drinking are needed to prevent and manage chronic diseases of the elderly.