Objective: To assess the magnitude and risk factors of the problem of depression in an elderly population of Pakistan. Method: A cross-sectional study was conducted using a sample of 402 people aged 65 and above visiting the Community Health Center of the Aga Khan University, Karachi. Questionnaire based interviews were conducted for data collection and the 15-Item Geriatric Depression Scale was used to screen for depression. Univariate and multivariate logistic regression analyses were performed to identify factors associated with depression. Results: Of the 402 participants, 69.7% (95% CI = 4.5%) were men, 76.4% (95% CI = 4.2%) were currently married, 36.8% (95% CI = 5%) had received 11 or more years of education and 24.4% (95% CI = 4.2%) were employed. The mean age was 70.57 years (SD = 5.414 years). The prevalence of depression was found to be 22.9% (95% CI = 4.1%) and multiple logistic regression analysis indicated that higher number of daily medications (p-value = 0.03), total number of health problems (p-value = 0.002), financial problems (p-value 0.001), urinary incontinence (p-value = 0.08) and inadequately fulfilled spiritual needs (p-value = 0.067) were significantly associated with depressive symptoms. Conclusion: We have identified several risk factors for depression in the elderly which need to be taken into account by practicing family physicians and health care workers.