Background <p>With the proposal of active aging and healthy aging, the elderly population’s demand for health services is increasing. Traditional Chinese Medicine (TCM), known for its simplicity, low cost, and proven effectiveness, has become a strategic option for addressing elderly health needs and reducing disease burden.</p> Methods <p>Data were drawn from the 2018 China Health and Retirement Longitudinal Study (CHARLS), covering 28 provinces and 450 communities. Descriptive analysis was used to report sociodemographic characteristics and health status. To identify the factors influencing the utilization of TCM health services among older adults, we first conducted χ² analysis to examine associations between categorical variables, followed by binary logistic regression to determine significant predictors.</p> Results <p>A total of 5,950 participants were included in the analysis. This study found that the utilization of TCM health services among older adults remains relatively low. The average number of times utilized TCM health services was 0.46 ± 1.03. Logistic regression analysis showed that the utilization of TCM health services among older adults was significantly influenced by predisposing factors (age and no alcohol consumption), enabling factors (supplementary medical insurance), and need factors (depression, multimorbidity, and self-assessed health status).</p> Conclusions <p>The utilization of TCM health services among older Chinese adults remains low and limited in scope. Future research should focus on expanding access, optimizing the allocation of TCM resources, training professionals, and promoting innovative research to better serve an aging population.</p>