Massive outmigration from the Hill Region of Nepal has various implications for the older people left behind. This article assesses their situation and the challenges they face. To capture older people's experiences and views on the effects of outmigration on their living conditions, I applied a livelihoods perspective. This study, based on in-depth qualitative interviews and group discussions carried out in 3 mountain villages, found that outmigration has had a profound effect on local economic and social conditions. Economic effects have included reduction and in some cases abandonment of agricultural land due to lack of labor. Socially, the elderly have experienced disrespect and neglect from the young, and they lament the demise of traditional Nepalese norms and values in society and in the family. Outmigration in combination with shifting demographics has created entirely new life situations for the elderly and has made their lives more difficult. This article contributes to an underresearched topic relevant to the mountain regions of the global South and draws attention to a social group that has frequently been overlooked in both development and migration research.