Because little is known about elderly Thai immigrants' conceptualization of depression, a qualitative descriptive research study was conducted to explore their perception of depression. Semi-structured individual face-to-face interviews were performed with a purposeful sampling of ten men and ten women aged 60 years and older at participants' homes or Thai Buddhist temples. The results revealed that depression was defined as feeling disappointment and pressure in the mind and included symptoms of isolation, heart pounding, and dissatisfaction. Coping strategies comprised practicing Buddhism and acceptance. Gender differences existed and reflected cultural expectations for men and women. These findings provide a foundation for developing culturally sensitive health care.