Standing balance is often more unstable when visually pursuing a moving target than when fixating on a stationary one. These effects are common in both young and older adults when the head is restrained during visual task performance. The present study focused on the role of head motion on standing balance during smooth pursuit as a function of age. Three predictions were tested: a) standing balance is compromised to a greater extent in older than young adults by gaze target pursuit compared to fixation, b) older adults pursue a moving target with greater and more variable head rotation than young adults, and c) greater and more variable head rotation during the smooth pursuit task is associated with greater Center of Pressure (CoP) sway. Twenty-two (22) older (age: 71.7 ± 8.1, 12 M / 10 F) and twenty-three (23) young adults (age: 23.6 ± 2.5, 12 M / 11 F) stood on a force plate while either fixating a stationary or smoothly pursuing a horizontally moving target (31.9° peak-to-peak visual angle). CoP (Bertec Balance Plate), head kinematics (Vicon Motion Analysis) and head-unconstrained gaze (Pupil Labs Invisible) were synchronously recorded. The root means square (RMS) of CoP velocity increased during smooth pursuit compared to fixation regardless of age (p < .05), while the interquartile CoP range increased only in older and not in young participants (p < .05). We also calculated the head rotation range (peak to peak cycle amplitude) of motion and variability (SD of range of motion) across the cycles of the smooth pursuit task. Older adults pursued the moving target employing more variable (p = .022) head yaw rotation than young participants although the mean range of head rotation was similar between groups (p =. 077). The amplitude and variability of head yaw rotation did not correlate with CoP sway measures. Results suggest that head-free pursuing of a moving target decreased balance to a greater extent in old than young individuals when compared to fixation. Nevertheless, postural sway during head-free smooth pursuit was not associated with the extent or variability of head rotation.