To explore the association between the hypersensitive C-reactive protein (hs-CRP) and activities of daily living (ADL) in elderly adults in longevity areas of China. This analysis included data on 2 352 adults aged ≥65 years from eight longevity areas from the Chinese Longitudinal Healthy Longevity Survey in 2012. We excluded information on adults who lacked ADL or blood test data; the final study population comprised 2 227 elderly adults. Using questionnaires, body measurement, and blood biochemical examination, information on demographic characteristics, lifestyle, ADL, blood pressure, blood lipids, and biomarkers was collected. Study participants who were able to independently carry out the six kinds of activities of daily living (bathing, dressing, indoor activities, toileting, eating, bowel and bladder control) comprised the normal ADL group, and those who could not were included in the impaired ADL group. A multivariate logistic regression model was used to analyze factors influencing ADL impairment. Among the 2 227 participants, 1 674 (75.2%) were included in the normal ADL group and 553 (24.8%) in the impaired ADL group. Among all participants. Adults in the normal ADL group had lower hs-CRP levels (P50 (P25-P75)=0.88; 0.38-2.29 mg/L) than those in the impaired ADL group (1.27; 0.47-4.28 mg/L); (Z=- 4.71, P<0.001). Participants in the normal ADL group also had lower hs-CRP elevation rates (214; 12.8%) than those in the impaired ADL group (125; 22.6%); (χ(2)= 31.06, P<0.001). Multivariate logistic regression analysis indicated that each age increase of one year increased the risk of ADL impairment by 1.08 times (OR 1.08 (95%CI: 1.07-1.10); P<0.001). Participants with increased hs-CRP levels, those of Han nationality, and participants with a previous history of stroke had a higher risk of ADL impairment (OR(95% CI) values were 1.42(1.04-1.94), 1.87(1.13-3.08), 2.81(1.87-4.23); P<0.05). Elderly adults who participated in recreational activities had a lower risk of impaired ADL (OR 0.29 (95%CI: 0.22-0.38); P<0.001). In this study among elderly adults living in longevity areas of China, hs-CRP levels were related to ADL and elevated hs-CRP was associated with a higher risk of ADL impairment.