This study examined factors related to falls among elderly home health clients living in rural southern Illinois. Forty-five clients who fell were demographically matched with 45 controls. Logistic regression analysis revealed that previous falls, frailty, physical inactivity, balance problems, absence of handrails, and uneven floors were related to a fall in this sample. Medications commonly taken by clients were not found to be related to a fall, whereas environmental factors appeared to contribute to a fall. Elderly home health clients need information and support services to recognize risk of falling and encourage preventive measures such as physical therapy and environmental modifications.