There is an association between gait performance and spinal alignment in elderly females but it is unclear if this association is gender-dependent and postural changes would also predict gait performance in healthy elderly males. We measured thoracic kyphosis angle (TKA), LLA as indices of spinal alignment and maximal walking speed (WS), timed up and go test (TUG), 10-m obstacle walking time, and 6-min walk distance as indices of gait performance in healthy old males (n = 124, age 73.0 ± 7.2 years). Knee extensor strength and one-leg standing time with eyes open were measures of physical function. The LLA but not TKA correlated with performance in each of the 4 gait test. Multiple-regression analyses showed that only the combination of knee extensor strength and LLA accounted for significant variation in gait performance. While previous studies showed that spinal alignment is associated with gait performance in elderly women, in healthy elderly males both functional (leg strength) and structural (spinal alignment) factors contribute to gait performance