OBJECTIVES: : To examine the associations of dimensions of religiousness with the presence and severity of depression in older adults. DESIGN: : Cross-sectional analysis of clinical and interview data. SETTING: : Private university-affiliated medical center in the Southeastern United States. PARTICIPANTS: : Four hundred seventy-six psychiatric patients with a current episode of unipolar major depression, and 167 nondepressed comparison subjects, ages 58 years or older (mean = 70 years, SD = 7). MEASUREMENTS: : Diagnostic Interview Schedule, Montgomery-Åsberg Depression Rating Scale, and Duke Depression Evaluation Schedule were used in the study. RESULTS: : Presence of depression was related to less frequent worship attendance, more frequent private religious practice, and moderate subjective religiosity. Among the depressed group, less severe depression was related to more frequent worship attendance, less religiousness, and having had a born-again experience. These results were only partially explained by effects of social support and stress buffering. CONCLUSIONS: : Religion is related to depression diagnosis and severity via multiple pathways.