OBJECTIVES: To examine the association between inhaled anticholinergics (IAC) use and all-cause mortality among elderly individuals with respiratory conditions after controlling for co-occurring chronic physical and mental health conditions and self reported perceived health status.  METHODS: Retrospective cross-sectional analyses of survey data from multiple years (2000-2005) of Medicare Current Beneficiary Survey (MCBS). Generic and brand names of IACs were used to identify IAC utilization from the self-reported prescription medication files. All-cause mortality was assessed using the vital status recorded in the enrollment file. Unadjusted group differences in mortality and IAC utilization rates were tested using chi-square statistic. Logistic regressions independent variables entered in separate blocks were used to analyze the association between IAC use and all-cause mortality after controlling for co-occurring conditions, demographic, socio-economic, health, functional status, smoking and obesity. Self-reported health status was used as a stratifying variable to control for selection bias associated with IAC use. All analyses accounted for the complex design of the MCBS.  RESULTS: Overall, 21% of the elderly Medicare beneficiaries used IAC. IAC use was significantly higher among those who reported fair to poor health compared to those with excellent to good health (28.5% vs. 18.0%). IAC use was not associated with all-cause mortality in the overall model. However, findings from the stratified regression indicated that IAC use was beneficial for those with fair to poor health [AOR: 0.62, 95% CI: 0.45, 0.85]. CONCLUSIONS: Among elderly individuals with respiratory conditions who reported poor perceived health status, IAC use may be beneficial in reducing the risk of all-cause mortality.