Background: Occupational therapy has undergone a paradigm shift back to a more occupation focused perspective. Occupational therapy theories mostly derive from a Western context and have been discussed as difficult to apply in other parts of the world. Aim: Was to describe occupational therapists' perspective towards implementation of occupation-based interventions [OBI] on elderly patients in communities in Northern Thailand. Method: A qualitative method with a semi-structured interview approach was conducted, following by a qualitative content analysis. Results: The results indicated that knowledge regarding OBI varied between the participants, some used and valued OBI highly, while it emerged that attitudes and expectations can complicate implementation. More resources are also needed. Conclusions: There is a need for more knowledge regarding OBI and more resources are needed to successfully implement OBI. Occupational therapists also need to include cultural values and attitudes in the process to successfully implement OBI. Implications: The result can be used to better understand how Thai occupational therapists work with elderly patients and their perspective on implementing OBI. The awareness of how culture affects occupation can be used in multicultural communities where occupational therapy is practiced.