OBJECTIVES: To evaluate the prevalence of low energy reporting (LER) and associations between LER and lifestyle, psychological and clinical parameters, in elderly people living in eastern Mediterranean islands. METHODS: 1190 men and women, aged 65-100 years, participated in this cross-sectional study. Socio-demographic, clinical and lifestyle characteristics were recorded for the study participants. Among others, the ratio of energy intake to estimated basal metabolic rate (EI/BMR) was calculated and was used for the assessment of LER. RESULTS: Prevalence of LER was 47.7%. Lower EI/BMR (i.e., higher risk for LER) was associated with older age (p=0.001), male sex (p<0.001), higher body mass index (BMI; p=0.04), lower adherence to the Mediterranean diet (p<0.001) and non-current smoking (p=0.007). The sex-specific analysis revealed that, lower EI/BMR values were associated with lower adherence to the Mediterranean diet and being non-current smoker in both men and women (p≤0.05), as well as with older age (p=0.01), higher BMI (p=0.02) and hypercholesterolemia (p=0.02), only in women. CONCLUSION: In elderly, several clinical and lifestyle factors seem to be related to LER, and they should be taken into account in their nutritional assessment.