Background <p>The aging adult population faces increasing challenges, including self-neglect and declining self-esteem, that significantly affect quality of life and psychosocial well-being. Addressing these issues has become a public health priority. Despite the topic’s importance, limited research has examined the relationship between self-neglect and self-esteem in the context of home care services. This study aimed to determine the relationship between self-neglect and self-esteem among older adults receiving home care services in Istanbul, Turkey.</p> Methods <p>This cross-sectional descriptive study was conducted from January to April 2024 among 148 older adults (≥ 65 years) enrolled in the Beşiktaş Municipality home-care program. Participants were selected using convenience sampling. Data were collected through face-to-face home visits by trained researchers, using the Personal Information Form, the Elderly Self-Neglect Scale (ESNS), and the Rosenberg Self-Esteem Scale (RSES). Statistical analyses included descriptive statistics, t-tests, ANOVA, Mann–Whitney U, Kruskal–Wallis H, and Spearman’s rank correlation (rho) tests, performed in SPSS version 26 at a significance level of <i>p</i> &lt; .05.</p> Results <p>A low but statistically significant association was observed between higher self-neglect scores and lower self-esteem (Spearman’s rho = 0.257, <i>p</i> &lt; .05). Men, individuals living alone, and those reporting social support had significantly higher self-neglect scores. Self-esteem was significantly associated with marital status, education level, and social activity, but not with gender or chronic illness.</p> Conclusions <p>The study indicates that lower self-esteem is linked to higher levels of self-neglect among older adults receiving home care. Interventions to enhance self-esteem and reduce self-neglect should focus on educational programs, psychological support, and increased social participation. Further studies with diverse populations are recommended.</p>