Background: Standing on textured surfaces or wearing textured shoe insoles can alter balance performance. This evidence, although inconclusive, offers a potential intervention for improving balance in older adults. This study explored the effect of standing on textured surfaces on double-limb balance in older adults and changes in muscle activity as a possible mechanism of effect. Methods: 50 healthy older adults (29 female, age mean [1SD] 75.1 [5.0]) stood quietly in six conditions-eyes open and closed on two different textured surfaces and a smooth surface control. Mediolateral sway, anterior-posterior sway and centre of pressure velocity were extracted from a force platform and lower limb muscle activity collected using surface electromyography (EMG) over 30 s. Results: For mediolateral range with eyes closed, there was a statistically significant effect of texture (F [2,47] = 3.840, P = 0.033). This was attributed to a 9.2% decrease with Texture 1 compared with Control. No such effects were seen in any other balance variable or lower limb EMG activity for either visual condition. Conclusion: The results suggest an effect of standing on textured surfaces on mediolateral sway in older adults, supporting further work to develop the therapeutic benefits of textured surfaces as an intervention to improve balance.