The purpose of this study was to determine the risk factors for root surface caries in the elderly and to evaluate the factors associated with gingival recession, one of the main risk factors for root surface caries. A total of 153 elderly people (35 men, 118 women) aged between 60 and 94 years (73.5±7.5 years) were surveyed. All participants were relatively healthy elderly who did not need special care in their daily lives. The survey was conducted in Chiba prefecture, Japan, and oral examinations and a questionnaire with face-to-face interviews were also carried out. Correlation analysis revealed that number of present teeth (p<0.001), gingival recession (p<0.001), bleeding on probing (p<0.001) and presence or absence of dentures (p<0.05) were significantly correlated with number of root surface caries. Stepwise multiple linear regression analysis for root surface caries revealed that the risk factors for increasing numbers of teeth with root surface caries were number of teeth with gingival recession (p<0.0001), bleeding on probing (p=0.0017) and self-reported dry mouth (p=0.0454). Sex (p<0.05), number of present teeth (p<0.001), bleeding on probing (p<0.01), the presence or absence of systemic disease (p<0.01), dentures (p<0.01), drinking alcohol (p<0.01) and smoking (p<0.01) were significantly correlated with amount of gingival recession by correlation analysis. Moreover, the risk factors for increasing number of teeth with gingival recession were living in an institution (p=0.0244), number of present teeth (p<0.0001) and smoking (p=0.0037), as determined by stepwise multiple linear regression analysis for gingival recession.