There is little information on the nutrient intake according to the city size and small town in Korean elderly. This study analyzed the nutritional consumption of older people in metropolitan, middle and small cities, and rural areas according to four income levels. The recent data from the 2016~2018 Korean National Health and Nutrition Survey, Centers for Disease Control and Prevention were used. The final analysis included 4,325 individuals (Male: 1,856, Female: 2,469) over 65 years old. Multivariable regression with a complex sample design was conducted to compare the nutrient intake among the groups. In a comparison within regions, the nutrition status of the elderly in small towns was more vulnerable than metropolitan and middle & small cities. The energy intakes were similar between the groups. The carbohydrate intake of middle & small cities was significantly higher than the other regions. The intake of other nutrients in metropolitan and middle & small cities appeared to be higher than in rural areas. The number of nutrients with statistical significance between low and high-income levels were 19 in metropolitan, 11 in middle & small cities, and 5 in rural areas. Each contribution of carbohydrate, fat, and protein to the total energy intake was lower in the low-income level than the high-income level in metropolitan and middle & small cities. On the other hand, in rural areas, only the contribution of protein to energy intake was lower in the low-income level than the high-income level. Cities with higher levels of urbanization had more severe nutritional inequality in relation to the income level. There was also nutritional inequality present in rural areas but it was to a lesser extent. Moreover, the generally low level of nutrient intake was problematic in rural areas. These findings could be used as fundamental evidence for developing community nutritional policies for the elderly.