This research aimed to assess nursing homes for the elderly with geriatric diseases in Japan, and to prepare the knowledge basis to develop nursing home for the elderly with geriatric diseases in Korea. For this, researcher visited 5 facilities in Tokyo from October 3 to October 9 in 2002, collected data by observations, interviews, and visual materials by taking photographs. Visual materials were analyzed according to the environmental assessment matrix consisted of supportiveness, flexibility, efficiency in perception, accessibility, safety, amenity, and social Interaction that were assorted and were given a name by these researchers in the process of this research. Among the characteristics of environmental design of the analysis cases, 992 items picked out from 722 visual materials were used in the analysis. The data were analyzed using the frequency and percentage with SPSS 11 program. The analysis results were the fellowing. The characteristics of recent nursing home design in Japan tended to focus on supportiveness, amenity, and efficiency in perception but to leave much desired in flexibility and safety. In each space, space to support outdoor activities tended to focus on efficiency in perception, space to support living activities tended to focus on amenities, space to support treatment and living tended to focus on supportiveness, space to support administration and operation tended to focus on supportiveness, and space to support movement tended to focus on amenities.