Objective: To explore the relationship between successful aging (SA) index and the survival status among elderly from longevity areas of China. Methods: A total of 2 296 old people aged ≥65 years old from 8 longevity areas were enrolled in our baseline survey in 2012. The information of demographics characteristic, life style, self-assessed health and mood or emotional state, cognitive function, abilities of daily living and physical activity were collected by questionnaire. There were 891 SA people in total, whose SA score was 4-5. 891 SA and 1 396 non-SA participated in the follow-up study in 2014. Finally, 860 SA and non-SA people were matched by orientation analysis. A Cox proportional hazards model was used to explore the relationship between successful aging index and survival status. Results: After 2 years of follow-up, a total of 1 442 elderly survived, with an average baseline age at (83.69±10.81) years old and 278 elderly people died, with an average baseline age at (93.41±9.05) years old. The mortality rate was 16.16% (278/1 720) in total, and it was 13.14% (113/860) in SA group, which was lower than it in non-SA group (19.19%, 165/860), and the difference was statistically significant (P=0.001). The analysis of the multivariate Cox regression showed that SA was the protective factor of the survival of the elderly after age and sex adjusted. Compared to the non-SA group, the risk of mortality rate in SA group decreased by 38%, the HR (95% CI) was 0.62 (0.49-0.79). Conclusion: The mortality rate in the SA group was low in the longevity areas in China; compared with non-SA group, the death rate in SA group reduced by 38%.