The elderly are a group vulnerable to experiencing various health problems, so one effort to improve and maintain the health of the elderly is through the utilization of health services, namely the Elderly Posyandu. However, elderly participation in the utilization of the Elderly Posyandu is still not optimal. This study aims to analyze the factors associated with elderly participation in the utilization of the Elderly Posyandu in the working area of Tenggaba Public Health Center, Southwest Sumba Regency, based on the Health Belief Model approach. The study used a quantitative design with a cross-sectional approach involving 96 elderly respondents selected through purposive sampling and proportional random sampling techniques, and data were collected through interviews using a questionnaire, then analyzed using the Chi-Square test. The results of the bivariate analysis showed that there was no significant relationship between perceived susceptibility (p=0.835), perceived severity (p=0.466), perceived benefits (p=0.559) and elderly participation in the utilization of Posyandu Lansia, while perceived barriers (p=0.000) and cues to action (p=0.019) showed a significant relationship with elderly participation in the utilization of Posyandu Lansia. The conclusion of this study shows that elderly participation in the utilization of Posyandu Lansia is related to perceived barriers such as long distances, forgetting the schedule, work, having other activities on the same day as posyandu activities, no transportation, and cues to action such as support from family, health workers, and cadres. Therefore, efforts to increase participation need to be focused on reducing the barriers perceived by the elderly group.