Diabetes and Hypertension (HTN) are the major contributing factors to the increasing burden of cardiovascular diseases (CVD), which is the leading cause of death in the elderly. Proper medication use and lifestyle modifications help in the prevention of disease progression and complications. A prospective interventional comparative study was carried out for 6 months to assess the use of pictograms as a patient counselling tool to convey information regarding medication use and lifestyle changes to geriatric in-patients with diabetes and hypertension. The secondary objectives were to assess the socio-demographic factors and to assess the knowledge of the patients regarding their medications. 120 patients were enrolled in the study on the basis of inclusion and exclusion criteria and were allocated into intervention and control groups using simple random sampling method. The patients in intervention group were counselled using pictograms accompanied with plain language and verbal counselling was used for the control group. The knowledge of patients’ regarding their prescribed anti-diabetic and antihypertensive medications were assessed pre-counselling and post counselling using Knowledge Attitude Practice (KAP) Questionnaire. The data obtained was subjected to statistical analysis. Out of the total study population, 55% were males and 45% were females. The mean age was found to be 70.95±6.52 years. The pre-counselling KAP scores was found to be generally poor. Post counseling, the mean KAP score increased to 12.83±2.06 in the intervention group and to 10.92±1.82 in the control group. It was also found that the post counselling KAP scores in the intervention group had no correlation with age, sex, literacy level and socio-economic status of the patients. The results obtained from our study show that counselling using pictograms generated better outcomes and that pictograms can be used as an effective patient counselling tool.