Background: Depressive symptoms are common among older people and are associated with disability, morbidity, and mortality. Its prevalence in primary care varies between 15.3-22%, with global prevalence up to 13% and between 17-46% in Saudi Arabia. Elderly persons are more vulnerable to depression. By the year 2020 depression would be the second major cause of disability adjusted life years lost, as reported by the World Health Organization. Depressive symptoms depressive disorders in elderly patients are associated with significantly higher health care costs, even after adjustment for chronic medical illness. Elderly persons sometimes dismiss less severe depression as an acceptable response to life stress or a normal part of aging. The elderly population with depression is on the rise in all communities. Aim: To estimate the prevalence and determinant of depression among elderly attendants in Al-Adl PHC center in Makkah Al-Mukarramah. Method: A cross sectional study conducted at outpatient clinics in Al-Adl primary health care center in Makkah Al-Mukarramah, 2018. Results: There were 345 participants, and the majority age were 60-70years. The majority were male65.2%. Most of the participants were widow58.8% while married were 41.2%. Illiterate were43.2%, primary education were30.1%. All the relations between depression and socio-demographic data were statistically significant except educated elderly patients not statistically significant. Conclusion: Depression is common among elderly persons and the point prevalence of depression is high in primary care visitors in Saudi Arabia. Gender and higher level of education were found to be significantly associated with screened depression. The majority of cases were mild to moderate, in utility and that screening for depression in a primary care setting is cost saving. Individuals providing healthcare to elderly persons must be to identify depression and take appropriate action; elderly persons with chronic diseases impairment deserve special attention.