This study examines the experiences of Mongolian family physicians in detecting elder abuse during medical encounters with older patients. Using thematic analysis, the study explores how physicians become aware of and respond to incidents of elder abuse. A total of 24 family physicians participated in semi-structured interviews. Four core themes, (1) encounters with elder abuse cases, (2) mechanisms of detection, (3) means of assistance, and (4) barriers to taking action, emerged from the analysis. The findings suggest that frequent interactions with older patients significantly influence physicians' overall identification of potential victims of elder abuse during their medical practice in primary care settings. The strategies used to assist potential victims during medical encounters vary widely. Barriers to reporting elder abuse cases are related to institutions, physicians, and patients. Significant measures for prevention of elder abuse in primary health care settings in Ulaanbaatar, Mongolia, are recommended.