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Objectives Due to increase in life expectancy, the number of aged population in the world is increasing. Focusing on various aspects of their health is important for improving their quality of life. One aspect is spiritual health, which is dependent on culture. This study aims to survey the spiritual health status of Iranian older adults. Methods & MaterialsIn this cross-sectional study, participants were recruited from among elderly people registered in the national electronic health record system using a stratified random sampling method. The Ajamzibad’s elder spiritual health scale was used to measure spiritual health and its dimensions including spiritual belief, centricity of God, altruism, spiritual conduct, and purposefulness of life. Trained healthcare workers completed questionnaires based on a telephone-based survey method in selected health centers. The non-parametric Mann-Whitney U and Kruskal-Wallis tests were used to analyze the data. Results Participants were 548 older adults from 28 provinces of Iran, with a mean age of 67.8±6.6 years. The mean total score of spiritual health was 91.2±10.0, with the highest score related to the spiritual belief (95.8%) and the lowest score related to the purposefulness of life (87%). Age had a statistically significant relationship with spiritual health in overall and all its dimensions (P<0.001). Educational level and marital status had a significant relationship only with the dimension of spiritual conduct (P=0.04). Conclusion The spiritual health of Iranian older adults is at a good level. Their level is higher in domains related to beliefs (spiritual belief and centricity of God), compared to those related to behavior (Altruism and Spiritual Conduct). Therefore, for improving their behaviors, there is need for attention, planning, and appropriate action. [ABSTRACT FROM AUTHOR]