Background: Population ageing is a global phenomenon and is associated with an increased burden of chronic diseases and mental health disorders. Cognitive impairment and depression are common psychiatric conditions affecting the elderly and usually coexist, causing significant morbidity, functional decline, and reduced quality of life. Hospital-based data on the prevalence of these conditions among elderly patients in India remain limited. Objectives: To determine the prevalence of cognitive impairment and depression among elderly patients attending a tertiary health care hospital and to assess their association with sociodemographic variables and comorbidities. Materials and Methods: Hospital-based cross-sectional observational study was done among 100 elderly patients aged 60 years and above attending the outpatient and inpatient departments of General Medicine at a tertiary care hospital. Data were collected using a structured questionnaire. Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE). Score <24 indicates cognitive impairment. Depression was assessed using the 15-item Geriatric Depression Scale (GDS). Score ≥5 suggests depression. Results: The prevalence of cognitive impairment was 38%. Depression was present in 44% of the study participants. Cognitive impairment was significantly more among patients aged 70 years and above. Depression was more prevalent among females. There is a statistically significant association between cognitive impairment and depression. Chronic comorbidities like hypertension and diabetes mellitus were commonly observed among participants. Conclusion: The study showed high prevalence of cognitive impairment and depression among elderly patients attending a tertiary care hospital. Routine screening and early intervention using simple assessment tools are essential to improve geriatric mental health outcomes