In recent years, smart home technologies have offered opportunities for elderly people to manage their daily health-related activities. Despite the advancement in smart home technology (SHT), the level of end-user acceptance among elderly people is still low. This study proposes an SHT framework by examining the determinants of elderly behavioural intention (BI) to use smart home technologies by extending the Unified Theory of Acceptance and Use of Technology (UTAUT) model. This study uses the quantitative approach to survey about 486 elderly people in Saudi Arabia, and it applies the Partial Least Square Structural Equation Model (PLS-SEM) technique to perform the data analysis. Findings reveal that culture influence and technology awareness are significant factors in determining the BI to use SHT among elderly people. The study also finds that attitude mediates the relationships between performance expectancy, effort expectancy, and behavioural intention. We find that region and education moderate the relationships between culture influence, technology awareness, and behavioural intention. This study theoretically extends the UTAUT theory by including external constructs: culture influence, technology awareness, attitude, education, and region.