This study aimed to clarify factors related to self-rated health among elderly people who live in geographically disadvantaged environments in sloped residential areas. A self-administered questionnaire was carried out among elderly residents aged 65 years or older living in a sloped residential area in Nagasaki City, Japan. Among a total of 148 respondents (46 males, 102 females), 35.8% demonstrated poor self-rated health. The factors statistically significantly associated with better self-rated health were going out, participating in social activities, and having relationships with neighbors. No relationship was found between self-rated health and sex/family structure. Logistic regression analysis showed that the factors associated with poor self-rated health were falls (odds ratio [OR]: 3.64, 95% confidence interval [CI]: 1.3-10.2), assistance with going out (OR: 10.43, 95%CI: 2.3-46.7), limited access to shopping (OR: 4.99, 95%CI: 1.8-13.7), and not participating in volunteer activities (OR: 5.26, 95%CI: 1.3-21.2). These results suggest that getting assistance when going out and voluntarily participating in social activities may improve the health of elderly residents living in sloped residential areas.