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Backgrounds: There was limited data specific to bystander cardiopulmonary resuscitation (CPR) in older out-of-hospital cardiac arrest (OHCA) patients in Thailand. Accordingly, the aim of this study was to determine the rate of bystander CPR and other types of prehospital management compared between older and younger OHCA patients in Thailand. Methods: This cross-sectional study was conducted using data from the cardiac arrest registry of a university hospital in Thailand from 1 January 2014 to 31 December 2019. All non-traumatic OHCA patients were eligible for inclusion except for EMS-witnessed OHCA and those pronounced dead at the scene. Included OHCA were categorized into the older (> 65 years) or younger (18-65 years) age groups. Results: The final analysis included 575 patients, and 328 (57.0%) of those were in the older age group. The shockable rhythm was significantly less in the older group than in the young group (OR: 0.4, 95% CI: 0.2-0.6). We found no significant difference between the older and younger groups for bystander cardiopulmonary resuscitation (CPR) rate (OR: 1.0, 95% CI: 0.7-1.5), public automated external defibrillator (AED) use (OR: 0.3, 95% CI: 0.1-1.1), emergency medical service (EMS) use (OR: 0.9, 95% CI: 0.6-1.3). Factors associated with bystander CPR in our cohort were OHCA witnessed by healthcare provider (adjusted OR (aOR): 21.7, 95% CI: 4.3-111.1) and EMS utilization (aOR: 8.4, 95% CI: 4.6-15.3). Conclusion: The citywide data suggests no significant difference in bystander CPR rate or other types of administered prehospital management between older and younger OHCA patients. [ABSTRACT FROM AUTHOR]