Abstract Background: Musculoskeletal disorders (MSDs) are a major contributor to pain, functional limitation, and reduced quality of life among the elderly. Age-related degenerative changes in the musculoskeletal system increase vulnerability to chronic pain, disability, and dependence. Standardized tools such as the Musculoskeletal Health Questionnaire (MSK-HQ) allow comprehensive assessment of physical and psychosocial impact. This study aimed to determine the prevalence of musculoskeletal disorders and their impact on musculoskeletal health and quality of life among the elderly population of Akolner, Maharashtra. Materials & Methodology: A community-based cross-sectional study was conducted among 93 elderly individuals aged ≥60 years in Akolner village, Maharashtra. Ethical approval was obtained prior to data collection. The validated Marathi translated MSK-HQ was administered to assess pain, physical function, fatigue, sleep, emotional well-being, independence, and physical activity. Data were analyzed using descriptive statistics and expressed as frequency and percentage. Results: The mean age of participants was approximately 72 years, with females comprising 54% of the sample. Daytime pain and stiffness were reported as moderate by 41.88% and very severe by 28.83%, while nighttime pain was moderate in 32.25% and very severe in 28.83%. Walking ability was moderately to severely affected in 59.52%, and 27.9% were unable to wash or dress independently. Physical activity was moderately limited in 36.27%, and 59.52% reported no engagement in ≥30 minutes of physical activity in the previous week. Emotional well-being was moderately affected at 38.69%, and 39.99% reported a very high overall impact of musculoskeletal symptoms. Discussion: The findings indicate that MSDs in the rural elderly population are highly prevalent and multidimensional, affecting not only physical function but also activity levels, sleep, and emotional health. Reduced physical activity and limited self-management capacity may further exacerbate functional decline. Conclusion: Musculoskeletal disorders are highly prevalent among the elderly in rural Maharashtra and significantly affect daily functioning and quality of life, highlighting the need for early screening, community-based physiotherapy, and health education programs. Keywords: Musculoskeletal disorders; Elderly; MSK-HQ; Functional limitation; Quality of life; Maharashtra.