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Background: Older adults with serious mental illness (OASMI) have to manage the twin challenges of old age and mental illness. Understanding their characteristics will help policymakers and researchers plan tailored interventions. The profile of OASMI is not described in any publication from India, and this paper addresses that gap. The information from this study will serve as a baseline for the planned periodic follow-up of the study participants. Methods: This study employed a cross- sectional design among a sample of OASMI identified through multistage cluster sampling from three districts in Kerala. We interviewed them in their households and collected sociodemographic data using a pretested tool. Results: Among the 917 OASMI participants, 66% were females, 18% were the ‘oldest-old’ (≥80 years), 94.1% were unemployed, 51.7% were socially backward, 68.5% were financially weak, 10.1% were living alone, 59.4% were living without partners, and 63.7% had caregivers. Conclusion: Compared to the general population of older adults in Kerala, the OASMI have poorer socioeconomic status and higher rates of social isolation, and males are dying earlier. The profile of the OASMI depicts their multiple vulnerabilities and the need to address those.