Purpose: The purpose of this study was to identify leisure activities, health promotion behaviors, and quality of life and regional differences in urban and rural elderly people. Method: This study was a descriptive research and data were collected from 198 elderly people using a questionnaire. Data were analyzed using the PASW WIN 18.0 Program. Result: Urban elders showed significantly higher rate for leisure activities compared to rural elders. While urban elders did not show a significant relationship among leisure activities, health promotion behaviors, and quality of life, rural elders showed a significant relationship among leisure activities, health promotion behavior, and quality of life. While the leisure activities and health promotion behaviors were influenced by recreational and social life in the urban elders, these activities and behaviors had no influence for rural elders. Leisure activities and quality of life were influenced by watching and enjoying activities, services and religious activities, and recreational and social life for urban elders but health sports was an influence for rural elders. Conclusion: Findings indicate regional differences and provide basic information to develop programs and leisure guidelines to enhance leisure activities, health promotion behaviors, and quality of life according to regional characteristics of elderly people.