Objectives. To examine the trends of leisure activity engagement among the oldest old in China for the past 2 decades.Methods. Our panel data came from the Chinese Longitudinal Healthy Longevity Survey, which systematically asked respondents about their current participation in leisure activities over a 20-year period. The final sample contained 66 789 interviews from 1998 to 2018. We applied generalized estimating equations regression models in our analysis.Results. Compared with 1998, odds ratios of television watching among Chinese oldest old individuals increased by about 2 to 3 times in 2018. Meanwhile, the odds ratio of exercise declined by 24%, mostly in men; playing cards and mah-jongg declined by about 30% for men. Results also showed that reading became less popular in the oldest old, and Chinese women tended to do more housework than before.Conclusions. Our findings indicated that Chinese oldest old persons have become more sedentary and solitary in the past 2 decades. The negative trend in leisure activity engagement among the elderly Chinese population warrants policy attention, and the urgent development of public health interventions is required to reverse such trends.