Purpose: The purpose of this study was to compare healthy life style and chronic disease management between urban and rural older adults. Methods: The study employed a comparative and descriptive survey design. Data were collected from 154 older adults living independently in communities (79 from urban and 75 from rural areas) using structured questionaries from 24 July, 2010 to 14 August, 2011. Results: Perceived health status was significantly lower in urban older adults than those in rural areas ($x^2$=13.27, p = .001). Frequency of regular health examination was better in the urban group than the rural group ($x^2$=4.71, p = .030). Among older adults with hypertension, medication noncompliance was higher, and participation rate in disease management education was lower in the rural group than the urban group ($x^2$=6.43, p = .040; $x^2$=23.51, p<.001, respectively) and the same as arthritis. Conclusion: Rural older adults had more problems with health and disease management in this study, might be, due to difficulties in access to health care services than urban residents. More tailored programs of disease management as well as health service programs and staffing should be developed in rural areas. For urban older adults, meal preparation program and more opportunities producing income may be needed.