Existing findings on body dissatisfaction in older adults are sparse. In addition, research suggests that chronic illness may elevate risk for body dissatisfaction. Accordingly, this study examined predictors of body dissatisfaction in 274 older adults with a disabling health condition. Most participants reported dissatisfaction with their weight, shape, and/or appearance. Higher body mass index and negative impact of health on appearance predicted body dissatisfaction. Gender comparisons revealed that depressed mood may fuel body dissatisfaction in women. Somatic symptoms predicted body dissatisfaction in men, despite men reporting lower somatic symptoms. Overall, results indicate substantial incidence of and unique risk factors for body dissatisfaction in this population.