Background <p>Older adults with chronic diseases often suffer from age-related challenges as well as the effects of their diseases. High self-compassionate engagement can help older adults cope with chronic diseases and may promote physical and mental health. However, there is little attention being paid to exploring self-compassionate engagement among older adults with chronic diseases in the Nepalese context. Thus, this study aimed to explore the meaning of self-compassion and self-compassionate engagement among older adults with chronic diseases.</p> Methods <p>A qualitative descriptive research design was employed with 15 purposively selected older adults residing in Kathmandu, Nepal, in consideration of data saturation. Face-to-face in-depth interviews [IDI] were conducted using an IDI question guideline. The data were analyzed using thematic analysis. The findings of this study were reported using the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.</p> Results <p>Three key themes emerged regarding self-compassionate engagement in chronic disease management by older adults. The first theme, self-kindness in action, encompasses six subthemes reflecting practical approaches, which consists of adapting to health limitations, seeking timely healthcare, medication adherence, dietary discipline, exercising, and utilizing self-care practices. The second theme, mindful engagement for self-awareness and balance, includes eight subthemes involving cognitive and emotional strategies such as reframing negative thoughts, nurturing inner strength, practicing yoga, engaging in recreational and spiritual activities, seeking support, and fostering self-awareness and emotional resilience through capacity-based actions. The third theme, viewing chronic disease as a shared human experience, emphasizes the role of common humanity. This study further identified significant barriers to self-compassionate engagement among older adults, encompassing denial of illness, fear of dependency, self-neglect, age-related limitations, and the perception of self-kindness as selfish.</p> Conclusion <p>Self-compassionate engagement among older adults with chronic diseases in Nepal encompasses practical self-care, mindful awareness, and acknowledgment of shared human experiences. Therefore, integrating self-compassion strategies into healthcare practice, community programs, and family support systems is recommended to enhance coping and overall health outcomes, while further research is warranted to explore self-compassionate engagement in multicultural and multinational contexts.</p>