Objective: Identify the prevalence and factors associated with the use of medication by elderly rural workers and verify the association between the use of medication and rural workload. Method: Cross-sectional, exploratory study, conducted among elderly rural workers from the state of Rio Grande do Sul. The data was collected through interviews, using a structured questionnaire. Results: Ninety-five elderly people participated in the study. Prevalence of medication use was 32% higher among women than men, and the type of medication most used by women was for the nervous and musculoskeletal systems. One additional degree in the frustration level with farm work resulted in a 1% increase in the probability of elderly people using medication. Conclusion: It is necessary to consider strategies that seek to reduce the physical and mental demand of rural work, through investments in public policies that enable elderly people to reduce rural labor for subsistence purposes and, consequently, their workload.