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BackgroundThe world is experiencing a demographic change – an explosion of the elderly population. However, the growing elderly population also poses a significant challenge for the government to ensure universal healthcare as people are physically and mentally vulnerable, especially in old age. This study, therefore, aimed to explore the health problems of the elderly among urban slum dwellers and identify the associated risk factors.MethodsThis cross-sectional study was carried out in four slums of Bangladesh’s Khulna city corporation (KCC). Data were randomly collected from 636 elderly individuals by administering a semi-structured interview schedule. Data were analyzed using IBM SPSS Statistics (version 26), and both bivariate [Pearson’s Chi-square (χ2) and Yate’s continuity correction (χ2Yate’s)] and multivariate (multivariable logistic regression) tests were executed.ResultsFindings indicate that 80 or above aged people were more prone to infirmity (AOR = 2.263, p < 0.01) than their younger counterparts, while people with relatively more education (AOR = 0.640, p p < 0.10) were less likely to be sick, respectively. Surprisingly, married elderly was also found to be sick (AOR = 2.443, p < 0.05) more than widow/divorced older adults. Meanwhile, older people capable of doing daily activities were prone to health problems (AOR = 1.077; p < 0.10), whereas people with higher life satisfaction were less vulnerable to sickness (AOR = 0.858; p < 0.01).ConclusionTo ensure universal healthcare coverage, particularly in urban areas and their slums, improving the financial and social protection mechanisms for the older people in Bangladesh is strongly recommended. Besides, policymakers should also emphasize family cohesion to support the elderly emotionally and financially when they are vulnerable.