Background: Nepal is experiencing a notable rise in life expectancy and increase the number of elderlies as well. The significance of enhancing the quality of life for the elderly is growing within societies, yet it remains an overlooked matter, particularly in developing nations. The objective of the study was to access and compare the QOL of elderly living with their family and in old age homes. Methods: A cross-sectional analytical study was conducted among 156 elderly (≥60 years) in the Bharatpur Metropolitan, Chitwan, Nepal. A total of 78 elderly were recruited from an old age home, and an equal number from a family setting. WHOQOL-BREF questionnaire was used to assess QOL, and descriptive and inferential statistics were used to analyze the data. Results: Overall QOL among the family setting is better than old age homes (p=0.009). Except for the social relationship domain of OAH, overall QOL and overall health perception were found to be significantly correlated with all domains of QOL (p=0.05 and p=0.01). Age, gender, caste, education, land ownership, high blood sugar, taking various types of medicine, and smoking habit were statistically associated with the different domains of QOL in both groups. Conclusions: Overall QOL tends to be better within a family setting and it is notable that the social domain of QOL is specifically linked to overall health. In order to promote a healthy and fulfilling life for the elderly, it is crucial to prioritize efforts towards improving their health and addressing their physical, psychological, and social wellbeing.