Objectives: The objective of this study was to examine the effects of Yang style Tai Chi exercises combined with mental imagery training on balance and fall prevention in the elderly. Methodology: It was a Randomized control trial, done on sixty patients. Participants were randomly assigned to either experimental group (63.94 ± 2.4 years) receiving motor imagery training with Tai Chi exercises while the control group (63.51 ± 2.7 years) performed only Tai Chi exercises for 8 weeks. Berg balance scale (BBS), Timed Up & Go test (TUG) mental imagery questionnaire-revised (MIQ-RS) and fall efficacy scale (FES) was used to evaluate the outcomes at baseline, 4th week and after 8th week of training. Results: The results showed that 38(63.3%) were males and 22 (36.6%) were females. BBS, TUG test, MIQ-RS, and FES showed significant (p<0.001) improvement within-group analysis, whereas between-group analysis showed non-significant improvement (p>0.001) on all outcome measures except mental imagery questionnaire which showed significant difference post-intervention in both groups. Conclusion: It is concluded that there was no significant difference between the groups while within-group significant difference was observed which showed that both techniques have equal effects on balance and fall prevention in the elderly.