Purpose: The purposes of this study were to investigate the degree of perceived health status, depression and the number of chronic diseases among rural elders and to identify factors related to depression in this population. Methods: We surveyed 1,014 elderly people using structured questionnaires. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson Correlation Coefficient and multiple regression using the SAS program (version 9.1). Results: There were significant differences in perceived health status according to gender (p<.001), education level (p<.001), medical support (p=.045), alcohol consumption (p<.001), number of chronic diseases (p<.001), and stage of exercise behavior change (p=.042). There were significant differences in depression score according to religion (p=.049), education level (p=.008), smoking status (p=.016), number of chronic diseases (p=.008) and stage of exercise behavior change (p<.001). Depression was negatively related to perceived health status and positively related to number of chronic diseases. Significant factors influencing depression were age, smoking status, stage of exercise behavior change, number of chronic diseases, and perceived health status. Conclusion: Multiple factors are associated with depression among rural elders. Findings of this study indicate the importance of considering chronic disease and perceived health status when planning programs to prevent depression.