Background: The use of all types of external devices was previously investigated for elderly with and without orthopaedic problems of a developed country. This study describes the proportion, types and the reasons of using a walking device in elderly who live in many rural areas of Thailand. Methods: Participants (n = 390) were interviewed using a questionnaire to ascertain their demographics, health status and types of walking device required for daily activities. Results: Forty-one participants (11%) used a walking device, particularly when walking long distances due to a fear of falling, musculoskeletal pain, and impaired walking ability. The proportion of walking devices used dramatically increased in participants aged 75 years and over (six times of those aged 60–74 years). Most of the participants used a modified walking stick by their own determination (81%), while only 7% used one according to medical prescription. A significant increase in the need of a walking device was seen in participants aged 75 years and over (OR = 13.9; 95% CI 5.9–32.7; P < 0.001), with a medical problem (OR = 45.9; 95% CI 6.7–73.4; P < 0.001) and who required regular medication (OR = 12.7; 95% CI 5.0–33.6; P = 0.001). Conclusion: The findings emphasise the importance of a community health service to promote health status, particularly before 75 years of age.