With advances in science, longevity of life is now a fact rather than a dream but a well-lived healthy life in totality is absent without the concept of spirituality. Elder population belongs to one of that vulnerable group who are at higher risk of mental illness than their younger ones. Major contributing factors to this are loneliness, reduced social networking, comorbid medical disorders, etc. Shea mentions that older people struggle between feelings of uselessness to thoughts of dying. Elderly in society struggles with different psychosocial aspects amounting to stress and decreased quality of life with their needs might not be fully met just with psychotherapy, social work, or other disciplines, maybe requiring something more. In a small pilot study by Ross, older subjects have reported their unmet needs related to religion, meaning, love and belonging, morality, and death and dying. Religion and spirituality play a significant role in the aged but are confused as interchangeable. While spirituality is more of a self-discovery toward purpose and existence of one’s life, religion is more of an outward expression of belief, attitude, or code of conduct. Erikson psychosocial stage of generativity refers to being a guide to others and of a meaningful existence which is in keeping with four interconnected core dimensions of spiritual needs, that is, connection, peace, meaning/purpose, and transcendence. Finding a meaning or purpose to life has been reported to have positive impact with decreased stress and improvement in mood states of the senior citizens. This chapter is going to run through the basics of spirituality with respect to elderly, brief about mental health issues, role of spirituality in elderly with and without health concerns, and positive impact in different aspects of old age.