Objective To prevent the fall of community elders with therapeutic recreation. Methods 248 elders from 4 communities were divided into intervention group (n=128) and control group (n=120). The intervention group accepted therapeutic recreation for 2 months, and were surveyed balance and attention ability before and after intervention. All the elders were followed up for 12 months, and their falling were recorded. Results 190 elders completed the studies. After therapeutic recreation, the functions of audition tracing, attention span, attention persistence, balance ability of intervention groups had improved. The incidence of fall intervention groups decreased 40%～54.5%, and the events of the fall decreased 45.5%～72.2% in the intervention group, but no changes in the control. The elders feared less for falling and knew more about prevention of fall in intervention groups. Conclusion Therapeutic recreation can improve attention and balance ability, psychological status and fall prevention consciousness, decrease the events of falling of community elders.