Background:Climate change poses significant health risks to various populations, particularly vulnerable groups such as rural older adults. Understanding the knowledge and attitudes of rural older adults regarding these climate change-related health risks is crucial for developing effective public health strategies and interventions. Thus, the aim of this study was to assess older adults’ knowledge and attitude regarding climate change health risks. Design: A cross- sectional descriptive research. The study was conducted at Sheiba village, which was randomly selected from 75 village which also was selected from the 21 districts of Sharkia governorate. The study conducted on 170 elderly. Tools for data collection: An Interview questionnaire consisted of three parts Socio-demographic characteristics of the elderly, older adult's knowledge related to their adaptation towards climate change consequences, and older adults' attitude toward efforts to combat climate change The results revealed that 38.2% of the studied elderly had total satisfactory knowledge about climate change while 61.8% of them had total unsatisfactory knowledge. Also, 58.3% of the studied elderly had negative attitudes towards combating climate change while, 71.7% of them had positive ones. Conclusion: less than two-thirds of the studied elderly had total unsatisfactory knowledge about climate change. Meanwhile, more than half of the studied elderly had negative attitudes towards combating climate change. Recommendations Developing and implementing educational programs and campaigns to raise elderly's awareness concerning climate change health risks especially among the rural residents.