Background: Dementia is a progressive neurodegenerative disorder that affects memory, cognition, and behavior, resulting in profound social and functional decline. Behavioral and Psychological Symptoms of Dementia (BPSD) are among the most distressing features, often influencing disease management and caregiver burden. The prevalence of dementia in India is estimated at 7.4% among individuals above 60 years of age. Aim: To explore the relationship between the severity of dementia and the presence of behavioral, emotional, psychotic, and biological symptoms among elderly patients. Methods: An observational study was conducted at Asha Hospital Memory Clinic over one year. Sixty patients above 60 years were screened according to inclusion criteria, and thirty completed the study. Dementia severity was assessed using Addenbrooke’s Cognitive Examination-III (ACE-III), Clinical Dementia Rating (CDR), and Neuropsychiatric Inventory (NPI). Data were categorized into behavioral, emotional, psychotic, and biological domains. Results: Among 30 participants (mean age 71 years), 16.7% had mild cognitive impairment, 26.7% mild dementia, 53.3% moderate dementia, and 3.3% severe dementia. Emotional symptoms (33.3%) were most frequent, followed by biological (24.7%), behavioral (22.2%), and psychotic (19.8%) features. Emotional and behavioral disturbances were most common in mild to moderate stages. Conclusion: BPSD were observed across all dementia stages, with emotional symptoms most prevalent. Early identification of BPSD is crucial for effective management and to minimize caregiver distress.