Background <p>With the global acceleration of urbanization and population aging, the growing contradiction between the built environment and the health needs of older adults has become increasingly prominent.</p> Methods <p>Based on the micro-data from the 2016, 2018, and 2020 waves of the China Longitudinal Aging Social Survey (CLASS) and the macro-data at the city level, our study selected eight indicators that reflected urban renewal at the household, community, and city levels and empirically investigated their effects on the self-assessed health of older adults.</p> Results <p>The study showed that urban renewal has a positive impact on the self-assessed health of older adults at the 1% significance level. The heterogeneity analysis indicated that the impact of urban renewal on the self-assessed health of older adults varied significantly across different geographical areas and age groups. However, further analysis revealed that urban renewal exacerbated the health inequality of older adults.</p> Conclusions <p>Our research indicated that urban renewal improved the self-assessed health of older adults, but it also increased health inequalities within this group. These results suggested that urban renewal should be further promoted to effectively enhance the health status of older adults, reduce health inequalities, and achieve the social goal of healthy aging.</p>