Background <p>Meeting spiritual needs of older adults with chronic illnesses in multicultural settings is challenging but vital for well-being, respect, and global health equity.</p> Methods <p>We conducted a qualitative study in culturally diverse regions of China to explore the spiritual experiences of older adults living with chronic diseases. Semi-structured, face-to-face interviews were conducted with a total of 28 participants, comprising 25 individuals suffering from chronic illnesses and 3 healthcare professionals. An inductive content analysis approach was utilized to analyze the data.</p> Results <p>Seven themes emerged, encompassing spiritual awareness, spiritual needs, spiritual resources, spiritual growth, spiritual equilibrium, spiritual outreach, and spiritual cultivation. The proposed model illustrates a spiraling growth trend in the spiritual experience of older adults. Regardless of their awareness of spirituality, the aging process prompts individuals to explore their spiritual needs and engage in spiritual experiences to varying extents.</p> Conclusions <p>Addressing spiritual needs of older adults with chronic illnesses in multicultural context is vital. Respecting cultural diversity and fostering spiritual growth enhances dignity, autonomy equity, and well being of older adults. The study model reveals dynamic spiritual experiences, highlighting the need for individualized interventions.</p> Clinical trial number <p>Not applicable.</p>