Introduction <p>Evidence from population-based longitudinal studies examining the association between rheumatic diseases and falls among older adults remains limited, particularly studies including both diseased and non-diseased populations. This study examined the incidence of falls among older adults with and without rheumatic diseases and assessed their longitudinal associations with falls in Indonesia.</p> Methods <p>This retrospective longitudinal study included adults aged ≥ 50 years from the Indonesian Family Life Survey (IFLS4: 2007–2008; and IFLS5: 2014–2015). Weighted Poisson regression adjusted for age, sex, functional strength, comorbidities, medication use, BMI, and prior falls. Subgroup analyses were also conducted.</p> Results <p>Older adults with rheumatic diseases had a higher incidence of falls than those without (16.2% vs. 11.7%). Rheumatic diseases were associated with increased risks of any fall (42%) and multiple falls (64%). Higher risks for any falls were observed among females and underweight individuals.</p> Conclusion <p>This first longitudinal population-based study in Indonesia shows that rheumatic diseases are associated with increased fall risk among older adults. Females and individuals with lower BMI are at higher risk for any falls, highlighting the public health importance of integrating targeted fall-prevention strategies and routine fall-risk screening into rheumatologic and primary care.</p>