The growing elderly population, declining fertility rates, and increasing youth migration in Iran have heightened the need for planning the location of elderly care facilities. This study assesses spatial suitability and prioritizes neighborhoods in Tehran using an integrated Analytic Hierarchy Process (AHP)–Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) approach. Ten criteria across four domains were identified and weighted. Subsequently, 352 neighborhoods were evaluated in four geographical groups, and 174 were identified as priority candidates based on spatial suitability. Sensitivity analyses were conducted by perturbing the AHP pairwise comparison matrix and varying criterion weights. The results, assessed through candidate-set overlap and Spearman’s rank correlation, indicated stability under the tested weight variations. However, comparing vector and Min–Max normalization in TOPSIS showed that the normalization method can alter candidate-set composition and ranking order. The chi-square test also revealed a significant difference between the observed distribution of candidate neighborhoods across Tehran’s municipal districts and the expected distribution proportional to the number of neighborhoods in each district. Overall, the proposed framework can support urban planning for elderly care facilities. However, determining the final locations requires integrating these findings with facility location models and collecting additional data on neighborhood-level elderly populations, service demand, existing facility capacity and distribution, and financial and operational constraints.