Promoted to acting air vice marshal on 1 January 1957 and to air vice marshal on a substantive basis on 1 July 1957, Elworthy became Deputy Chief of the Air Staff with the acting rank of air marshal on 15 November 1959. Appointed a Companion of the Order of the Bath in the 1960 New Year Honours and promoted to air marshal on a substantive basis on 1 July 1960, he became Commander-in-Chief British Forces Arabian Peninsular in August 1960. Advanced to Knight Commander of the Order of the Bath in the 1961 New Year Honours, he became Commander-in-Chief Middle East Command (Aden), a newly formed unified command, in March 1961. He was advanced to Knight Grand Cross of the Order of the Bath in the 1962 New Year Honours.