Objective: The purpose of this study was to examine the role of spirituality in the self-management of chronic illness among older women with chronic conditions. Methods: A sample of 41 African-American and non-Hispanic White women, of age 66 and older, participated in the process of self-care study. Data were collected from semi-structured interviews and analysed for common themes using the Grounded Theory method. Results: Audiotaped and transcribed interviews identified four categories that emerged to suggest the influence of spirituality in behavioural change and disease management: (1) God’s involvement in illness management; (2) prayer as a mediator; (3) spirituality as a coping mechanism; and (4) the combination of conventional and spiritual practices. Discussion: Older women with various chronic illnesses defined ‘spirituality’ in a broad, holistic way, and the findings suggest that spirituality played a part in documenting the self-management process. Knowledge of spirituality and the role it plays in illness management may assist public health gerontologists in designing effective and culturally appropriate self-management programmes.