<p>Telephysiotherapy (TPT) proves advantageous for meeting the growing needs of the elderly population, particularly by overcoming the constraints of conventional physiotherapy. This study aimed to explore older adults’ perspectives on TPT acceptance and identify the core factors influencing TPT adoption and non-adoption among the elderly population. Using a qualitative approach, in-depth insights into older adults’ perspectives were gained through 40 individual interviews, and the resulting data were analyzed using a three-step coding process. Upon meticulous examination, a grounded theory model was formulated to delineate the factors that govern the adoption and non-adoption of TPT within the elderly population. It was revealed that older adults generally exhibited a positive attitude toward using TPT. Various factors emerged as influential determinants of TPT utilization among older adults, including utilitarian outcomes, social influence, risk perception, trust, self-efficacy, intrinsic motivation, health awareness, adaptive design, training, subsidy scheme, complexity, privacy issues, reluctance to change, technology anxiety, lack of assistance, and inaccessibility. The insights gleaned from this study have significant practical implications for increasing the use of TPT among older adults. By elucidating the determinants of older adults’ engagement with TPT, policymakers and TPT providers can develop targeted strategies to promote TPT adoption among older adults and its implementation in the healthcare sector. TPT should be promoted for older adults with mobility limitations residing in remote locations or at risk of exposure to infectious diseases in healthcare settings.</p>