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The purpose of this study was to examine the predictors of health promotion lifestyle (HPL) and examine the similarities and differences among three ethnic groups of elderly rural women in Taiwan. Pender's Health Promotion Model was used as the conceptual framework of this study. A convenience sample of 599 elderly rural women was recruited from three rural areas: Kao-Shu, San-Di-Men, and Ma-Chia. Ho-Lo, Hakka, and aboriginal people are the three main ethnic groups in these areas. Of the 599 elderly women, 391 completed all of the interview questions. Subjects ranged from 65 to 91 years old. All instruments used in this study have been evaluated for their content validity. The interrater reliability and alpha coefficient reliability of all instruments were greater than 0.70. A survey-interview method was used to collect data. Findings showed that the predictors of HPL have differences and similarities among elderly rural women from different ethnicities. In the group of elderly Ho-Lo women, age, education, living arrangements, and perceived barriers to health promotion lifestyle (PBaHPL) were significant predictors and they explained 41.9% of total variance in HPL. In the group of elderly Hakka women, education, number of chronic health problems, PBaHPL, and perceived benefits of health promotion lifestyle (PBeHPL) were significant predictors in explaining 53.9% of total variance in HPL. Finally, in the group of elderly aboriginal women, living arrangements, PBaHPL, and PBeHPL were significant predictors in explaining 70.0% of total variance in HPL. Community nurses can use their understanding of different ethnic groups to assess, identify, and use effective health promotion interventions for elderly rural women.