Abstract Background: Depression is the most common mental health problem affecting older patients with cancer. It’s associated with mortality risk, non-compliance with treatment, and chemotherapy intolerance. Aim of the study: Assess depressive symptoms and its influencing factors among elderly cancer patients receiving chemotherapy. Subjects and Methods: Research design: A descriptive design was utilized. Setting: The study was conducted at the oncology department at Zagazig University Hospitals, Egypt. Subjects: purposive sample composed of 194 older adults aged ≥60 years. Tools of data collection: two tools were used to collect the study data: I) a structured interview sheet. II) Geriatric Depression Scale short form. Influencing factors were identified by using chi-square and multiple linear regression analysis. Results: among the studied elderly, 37.1% had mild depressive symptoms, 12.9% had moderate, and 18.6% had severe depressive symptoms. Statistically significant relations were found between depressive symptoms and female gender, illiteracy, insufficient monthly income, living alone, comorbidities, lung cancer, cancer stage four at diagnosis, and receiving ≥4 chemotherapy cycles. Conclusion: high prevalence of depressive symptoms and many influencing factors were identified among older patients with cancer receiving chemotherapy. Recommendation: ongoing assessment of depressive symptomatology of older adults along with chemotherapy with consideration of the influencing factors is a must for early intervention and better outcomes. Keywords Depressive symptoms, elderly, cancer, chemotherapy, influencing Factors