Background <p>Compensatory movement patterns in older adults may reflect biomechanical abnormalities and sensorimotor system impairments, which can increase the risk of falls. This study aimed to compare static and dynamic balance, knee proprioception, and fear of falling in older men with and without a dynamic knee valgus.</p> Methods <p>This causal-comparative study included 60 older men aged 60–70 years from Urmia, Iran. Participants were divided into two groups (<i>n</i> = 30 each) with and without a dynamic knee valgus, determined through observational assessment of knee alignment during a squat task. Static balance was evaluated using the Sharpened Romberg test, dynamic balance using the Timed Up and Go (TUG) test, knee proprioception using a photogrammetry-based method, and fear of falling using the Falls Efficacy Scale–International (FES-I). Data were analyzed using independent samples <i>t</i>-tests with a significance level set at 0.05.</p> Results <p>Participants with a dynamic knee valgus demonstrated significantly poorer performance in all measured variables, including static balance (with eyes open and closed), dynamic balance (TUG), knee proprioception, and fear of falling, compared with those without knee valgus (<i>p</i> &lt; 0.001).</p> Conclusion <p>A dynamic knee valgus may serve as a clinical may be associated with impaired balance and sensorimotor function in older adults. Early identification of this pattern during screening assessments may be associated with fall-related risk factors and inform the design of targeted sensorimotor corrective interventions.</p>