A comparative analysis between centenarians' children and neighborhood controls is an efficient approach to learn how familial longevity influence and its interaction with environmental factors affect healthy aging. Yet, there are few extant studies that inform this topic; this study expands this literature. We analyze data from 417 children of centenarians and 560 neighborhood controls without family history of longevity in China (all participants aged 60-80) using ordered logit regression models. We found that, compared to the neighborhood controls and adjusted for various potentially confounding factors, centenarians' children had significantly better instrumental activities of daily living function(p < .001), smaller number of chronic conditions or health problems(p < .01), less anxiety and loneliness(p < .01), better cognitive function (p < .01), more resilience (p < .01), better self-rated health (p < .001), and better self-rated life satisfaction (p < .001). The results also reveal that interactions between familial longevity influence and one of three environmental factors (whether, as children, they received adequate medical care when ill, number of living children, and household economic conditions) may possibly affect health outcomes at old ages (p < .05). We discovered that effects of the environmental factors on health outcome are substantially stronger among elders who have no family history of longevity compared to centenarians' children who probably carry positive genes and/or lifestyle behaviors from their long-lived parent(s), which may promote longevity. Familial longevity influence, through genetics and family lifestyle, is significantly associated with various aspects of health at older ages. Interactions between familial longevity influence and some environmental factors may affect health in old age.