Background: Peptic ulcer disease (PUD) is a common gastrointestinal condition, marked by mucosal erosion due to gastric acid and pepsin. It represents a major health risk, especially among elderly patients. Aim: To assess knowledge and reported practices of elderly patients with PUD. Research design: A cross-sectional descriptive research design was used. Setting: This  research was carried out in the Gastroenterology department and outpatient clinics at Aswan University Hospital. Sample: A purposive sample of 100 elderly patients with PUD. Tools of data collection: Three tools were used: Tool I: An interview questionnaire consisted of two parts: First part: Demographic characteristics; second part: Medical history related to PUD. Tool II: Knowledge of elderly patients regarding PUD. Tool III: Practice of elderly patients regarding PUD. Results: 63.0% of the elderly patients were smokers. Epigastric pain 92% and acidity 87% were the most common symptoms. Also, drinking excessive caffeine 81% and smoking 63% were the main predisposing factors. About 67.0% of the elderly had an unsatisfactory knowledge regarding PUD, and 52.0% from them had an unsatisfactory reported practice regarding PUD. Conclusion: The study indicate that one-third of the elderly demonstrated satisfactory knowledge regarding PUD, while nearly half of them had a satisfactory reported practice regarding PUD. A significant positive correlation was observed between knowledge and practice levels. Recommendation: Tailored health education programs should be developed to improve knowledge and promote effective self-practices among elderly patients with PUD.