Purpose <p>This study investigates the prevalence of elder abuse and its ramifications for older individuals living in Chinese households. It explores the mediating role of social support and the moderating influence of self-rated physical health on the relationship between elder abuse and depressive symptoms.</p> Methods <p>Data from 7,111 older adults in the 2018 China Longitudinal Aging Social Survey (CLASS) were analyzed. Elder abuse was categorized into psychological abuse, physical abuse, financial exploitation, and neglect. Depressive symptoms were assessed using the revised Center for Epidemiologic Studies Depression Scale (CES-D). Analytical methods included multiple linear regression, propensity score matching, and mediation analysis.</p> Results <p>Elder abuse prevalence was 5.54% (<i>n</i> = 394), with neglect (64.47%) and emotional abuse (47.97%) most common. Differences in abuse prevalence were associated with gender, living arrangements, and self-rated health. Elder abuse was positively associated with depressive symptoms (β = 1.103, <i>p</i> &lt; 0.001). Objective social support reduced depressive symptoms (β = -0.044, <i>p</i> &lt; 0.001), while perceived social support unexpectedly increased them (β = 0.824, <i>p</i> &lt; 0.001). Better self-rated health moderated the negative impact of abuse. Mediation analysis confirmed perceived social support partially explained the elder abuse–depressive symptoms link.</p> Conclusions <p>The research demonstrates that elder abuse has a negative effect on the mental health of Chinese home-dwelling older adults. Hence, families and communities should provide more emotional support to this population group. This would not only benefit the health of older adults but also foster intergenerational harmony and contribute to the development of stronger familial bonds.</p>