Background: The risk of impaired postural balance and falls with potentially life threatening injuries (e.g. brain injury, hip fractures) is high in the older adults. Hypothyroidism is associated with impaired neuromuscular function. Objective: To assess the effects of hypothyroidism on postural balance in the older adults. Methods: Older adults (≥65 years) participants with either normal (Euthyroid) or hypothyroid status were enrolled in a prospective observational study. The BRIEF BESTest (BBT) was used for assessing balance. The primary outcome was the total BBT scores between the two groups of participants. Results: 66 participants (33 per group) were recruited over 12 months. The mean (±SD) age, weight and height of hypothyroid vs euthyroid group participants was 76.39 (±6.48) vs 76.18 (±7.94) years, 67.33 (±6.49) vs 64.15 (±5.14) kg and 170.53 (±10.00) vs 166.83 (±13.86) cm respectively. The mean (±SD) total BBT scores were significantly lower [10.818(±2.66) vs 12.515 (±3.52), p=0.039] in the hypothyroid vs euthyroid group participants respectively. Of the individual BBT components, anticipatory postural adjustment (left side), reactive postural response (both sides), and sensory orientation scores were significantly less in hypothyroid participants. Conclusion: Hypothyroidism was associated with adverse effect on balance in the older adults