Objective: The purpose of this qualitative study was to identify features related to perception of falls among older adults living at home in a metropolitan area.Methods: The participants comprised 10 older adults (4 men; 6 women; from 8 families) over 75 years of age who were currently receiving medication at a clinic in Tokyo. Data were collected through home observation visits and semi-structured interviews regarding falls and near-falls in the home, fall prevention measures, and the experience of their friends in relation to falls. All interviews were recorded and transcribed. Descriptions concerning perception of falls were extracted and then analyzed using the KJ method.Results: Based on the analysis, we identified the following relationships regarding perception of falls among older adults living at home: “Fall prevention measures” was the opposite of “No fall prevention measures”; “Fall prevention measures” was associated with “Experience of their friends”, “Image of falls”, “Awareness of aging”, “Perception of carefulness”, and “Perception of carelessness”; and “No fall prevention measures” was associated with “Perception of safety”. “Carelessness” and “Misunderstanding” were also identified as descriptors related to perception of falls.Conclusion: “Fall prevention measures” was primarily associated with anxiety and fear of falls, awareness of aging, and fall risk, whereas “No fall prevention measures” was associated with falls self-efficacy, overconfidence, and a priority on convenience. These issues should be considered when developing health education programs that promote the prevention of falls in older adults living at home.