This study used a lens of life world-led care to describe the lived experiences of elderly and the role of Accredited Social Health Activists (ASHAs) in supporting elderly persons with attributes of the cardiometabolic syndrome. The study included a survey on self-reported morbidity among 120 persons (60 men) aged 60 years and above residing in Manikkal grama panchayat, Thiruvananthapuram, India, shadowing of five ASHA workers and in-depth interviews with one ASHA worker and five elderly participants, maintaining transcripts, and detailed field notes with reflective observations. Quantitative data were summarized into means and standard deviations or proportions and a life world concept was used to describe experiences of elderly persons and interactions with ASHA workers. At least one attribute of cardiometabolic syndrome was reported by 75% of men and 80% of women, with women reporting multiple conditions more frequently. The panchayat conducts monthly “cluster meeting” of elderly persons in neighborhood groups of 20–25 such persons where ASHAs monitor blood pressure and blood sugar. Elderly life worlds were complex, involving temporal, spatial, and intersubjective experiences. These self-expressions diverged extensively from cardiometabolic syndrome, despite the high self-reported magnitude. ASHA workers, embedded within their communities, could provide support with a good understanding of elderly life worlds. ASHA workers engage with the elderly deeply within their life world contexts, embodying diverse social relationships and thus were vital allies in the health journey of elderly individuals facing the complexities of cardiometabolic syndrome.