Objective <p>This study used data from the China Health and Retirement Longitudinal Survey (CHARLS) to examine the association between adverse childhood experiences (ACEs) and accelerated aging in middle-aged and older Chinese, with implications for healthy aging interventions.</p> Methods <p>A total of 8327 participants aged 45 years and older were selected from the 2011 baseline survey. Accelerated aging was defined using biological age estimated from 2011 biomarker data. Information on ACEs was obtained from the 2014 life history questionnaire. Three multivariable logistic regression models were used to assess the association between ACEs and accelerated aging, and restricted cubic spline (RCS) analysis was used to test potential non-linear patterns. Exploratory subgroup analyses were conducted to examine whether the association differed across demographic, socioeconomic, lifestyle, and disease-status groups.</p> Results <p>Each additional ACE type was associated with a 5% increased odds of accelerated aging (OR = 1.05, 95% CI: 1.02–1.08). This association remained significant after adjustment for all confounders (OR = 1.05, 95% CI: 1.01–1.08). Individuals with ≥ 4 ACE types had significantly higher odds of accelerated aging (OR = 1.20, 95% CI: 1.01–1.44), showing a dose-response relationship (<i>P</i> for trend &lt; 0.05). The RCS analysis did not show a significant non-linear relationship, but indicated that the overall odds increased with the number of ACEs types (p-overall &lt; 0.05). Exploratory subgroup analyses showed no statistically significant interactions across subgroups (all <i>P</i> for interaction &gt; 0.05), suggesting no clear evidence of effect modification.</p> Conclusion <p>Among the middle-aged and older population in China, adverse childhood experiences are positively associated with accelerated aging, showing a cumulative effect. Strengthening community support, social services and policy measures may help to mitigate the long-term adverse effects of ACEs on healthy aging.</p>