OBJECTIVES: To determine whether foot pain and plantar pressure are associated with falls in community-dwelling older adults. DESIGN: Community-based cohort study with 12-month prospective falls follow-up. SETTING: Sydney and Illawarra statistical regions of New South Wales, Australia. PARTICIPANTS: Randomly recruited, community-dwelling adults (158 men and 154 women) aged 60 and older. MEASUREMENTS: Manchester Foot Pain and Disability Index to establish baseline foot pain and dynamic plantar pressures. Participants were then classified as fallers (n=107) or nonfallers (n=196) based on their falls incidence over the following 12 months. RESULTS: Fallers had a significantly higher prevalence of foot pain than nonfallers (57.9% vs 42.1%; chi-square=4.0; P=.04). Fallers also generated a significantly higher peak pressure and pressure-time integral under the foot than non-fallers. In addition, individuals with foot pain had a significantly higher peak pressure and pressure-time integral under the foot than those without foot pain. CONCLUSION: High plantar pressures generated during gait may contribute to foot pain and risk of falls. Providing interventions to older people with foot pain and high plantar pressures may play a role in reducing their falls risk.