Purpose: To assess the effect of an edentulous state on sleep quality in the elderly. Materials and methods: A case–control study was carried out in which a total of 100 elderly individuals aged over 60 years were enrolled. Of these, 50 were edentulous and comprised the case group, while 50 age-matched dentulous elderly individuals comprised the control group. Body mass index (BMI), medical history, activity level, and personal habit profiles of both groups were noted. Sleep quality assessment was done using the Pittsburgh Sleep Quality Index (PSQI). PSQI scores greater than five were considered indicators of poor sleep quality. Chi-squared and independent samples ”t-tests” were used for univariate analysis. Linear regression was performed for multivariate analysis. Results: The mean age of cases was 68.82 ± 5.20 years (range 61–78). The majority of cases were females (56%). Cases had a significantly higher mean BMI and proportion of those with a sedentary activity profile compared to controls. The maximum number of cases had been in an edentulous state for <6 months (42%). The mean sleep quality scores for PSQI domains, including latency, duration, subjective sleep quality, daytime dysfunction, and habitual, were significantly higher in cases compared to controls. The overall mean total PSQI score was 13.50 ± 2.92 in cases compared to 6.99 ± 2.05 in controls (p < 0.001). The majority of cases had moderate-to-severe sleep disturbance (88%) compared to only 1 (2%) of controls (p < 0.001). On linear regression for PSQI scores, only age and edentulous state emerged as independent significant factors associated with PSQI scores (p < 0.05). Conclusion: Edentulous state contributes to poor sleep quality in elderly patients. Interventions to improve sleep quality in elderly patients with an edentulous state should be done.