Introduction: Failure to regain balance, falls, and associated injuries are main geriatric problems. Lack of exercise and poor fitness are responsible for decrease in muscle strength leading to falls. Balance exercises help to maintain balance, improve balance recovery and reduces risk of falls. Multi- directional training is necessary for daily activities, as 35 - 50% steps are non- straight steps that change direction of movement. Aim/ Objective: To assess effect of multi-directional training along with conventional physiotherapy on balance in elders when compared with conventional physiotherapy. Methodology: Study was conducted in old age homes in Surat. 58 elders were included and divided into 2 groups: group -1 CPTG (conventional physiotherapy group) and group - 2 MDSTG (multi-directional step-up training along with conventional physiotherapy) and received training for 5 sessions / week for 4 weeks. Mini - Best test (MBT) was used to assess balance at baseline and after 4 weeks of intervention. Wilcoxon rank test was used for within group analysis and Mann - Whitney U test was used for between group analyses. Result: After 4 weeks of intervention, both groups showed significant improvement, but multi-directional training group showed more improvement in balance in elders (p