Background <p>Access to palliative care among elderly populations remains a global challenge, especially in regions where cultural beliefs, financial barriers, and healthcare infrastructure intersect. In Saudi Arabia, these challenges may be amplified due to social norms and service limitations.</p> Objectives <p>To explore the experiences and perspectives of older adults in the Riyadh region regarding their access to palliative care, with a focus on identifying key barriers, facilitators, and sociocultural influences.</p> Methods <p>A qualitative study using semi-structured face-to-face interviews was conducted with 18 elderly participants (aged 65–89) who had experience with or were recommended for palliative care. Thematic analysis followed Braun and Clarke’s six-step approach.</p> Results <p>Four key themes emerged: (1) limited awareness and misconceptions about palliative care; (2) financial and logistical access barriers; (3) sociocultural influences, including family roles and cultural taboos; and (4) variability in provider communication and continuity of care.</p> Conclusion <p>Palliative care access for older adults in Saudi Arabia is shaped by a complex interplay of personal, systemic, and cultural factors. Culturally sensitive education, improved provider communication, and home-based service models may improve access and equity.</p>