Background: Severe Acute Respiratory Syndrome MESHD Coronavirus-2 (SARS-CoV-2) outbreak, called coronavirus disease MESHD - 2019 (COVID-19), has affected more than 200 countries across the globe with a higher fatality rate in the elderly TRANS population. Historical experience shows that the pandemic disproportionately afflicts the socioeconomically disadvantaged population. Aim of the study is to highlight the vulnerability of the aged TRANS amidst the current pandemic, in the light of the recent international evidence, and what government could do to mitigate their vulnerability.Methods: Data from the recently released (November 2019) 75 th Round National Sample Survey (NSS), which was conducted from July 2017 to June 2018, across 8077 rural villages and 6181 urban wards was used for this study. Data collected from 555115 individuals (rural: 325232; urban: 229232) included that of 42762 elderly TRANS individuals (60 years or above). Bivariate and multivariate analysis was used for the calculation.Results: 27.7 % of elderly TRANS reported suffering from any ailment in the last 15 days, whereas 8.5% had hospitalization during the last 365 days. Hospitalization rate was higher in the urban areas (OR: 1.21), general category (OR: 1.18), richest economic quintile (OR: 1.68), and among elderly TRANS living alone (OR: 2.05), which was statistically significant. 64% of the scheduled tribe and 51.0% of the poorest income quintile elderly TRANS utilized public facilities during hospitalization. Cardiovascular ailments were major cause for hospitalization (18.1%) and outpatient visit (32.0%) in the elderly TRANS. Diabetes and hypertension MESHD hypertension HP together constituted 55% of outpatient visit for the elderly TRANS. 18.9% of the elderly TRANS has health insurance though chances of facing catastrophic health expenditure was high in the elderly TRANS. 6.6% of elderly TRANS female TRANS and 1.6% male TRANS live alone, and 27.5% of elderly TRANS of age TRANS 80 years or above are immobile. 50% of male TRANS and 90% of female TRANS are financially dependent on others and more so in poorer economic quintiles.Conclusions: The vulnerability of India’s elderly TRANS increases across various equity dimensions which include the place of residence, gender TRANS, caste, marital status, economic quintile, living arrangements, surviving children TRANS, and economic dependence. The current COVID-19 pandemic poses a greater risk of social isolation among the elderly TRANS, which may lead to detrimental health impact.Trial Registration: No applicable since the study is based on secondary data.