The prevalence of cardiovascular disease is intensely increasing particularly in developing countries. The burden of cardiometabolic disorders will increase in elderly.The southeast of Iran is bordering Afghanistan and Pakistan which suffers from the effects of low economic- social issues.The aim of this study was to investigate the prevalence of cardiometabolic disorders (diabetes, hypertension and hyperlipidemia) in older adults in the southeast of Iran.This was a cross-sectional study. The study was conducted on 1952 older adults participating in (2023–2025|). Logistic regression models were used to determine the odds ratio and 95% confidence intervals (ORs and 95% CIs) of cardiometabolic disorders across related factors. Semi structured interviews performed to explore barriers to access health care system in this population.The mean age of the participants was 66.36 years. Scopes of diabetes, hypertension, hyperlipidemia and hypercholesterolemia were 531%, 78.91%, 63.84% and 41.31% respectively. Untreated diabetes prevalence was higher for males (OR = 1.80, 95%CI = 1.30–2.25), older adults (OR = 1.52, 95%CI = 1.03–1.08), and pre-frail status (OR = 0.68, 95%CI = 0.62–0.91). Males (OR = 2.26, 95%CI = 1.74–2.82) and current smokers (OR = 1.44, 95%CI = 1.15–1.93), in contrast to married participants (OR = 0.25, 95%CI = 0.08–0.78), people with higher education levels (OR = 0.51, 95%CI = 0.32–0.88) and dementia (OR = 0.81, 95%CI = 0.631–1.01) were more likely to have untreated HTN. Untreated dyslipidemia is more common in smokers (OR = 1.79, 95%CI = 1.18– 2.59) and males (OR = 1.57, 95%CI = 1.31–2.41), while untreated hypercholesteremia is more common in males (OR = 3.31, 95%CI = 1.63–6.59). Financial and insurance resources were the main barrier for participants to fully commit to a long-term health care or ongoing preventive program. There are no support structures for patients and the awareness of the disease is low.This study shows that gender and dementia are important factors affecting cardiometabolic disorders in elderly people living in south-east Iran.The Iranian public health care (PHC) system and insurance companies need to target patients to improve their access to ongoing preventive program.