<p>In China, older couples typically adhere to traditional, female-dominated household labor division patterns while experiencing the interplay between traditional and modern influences, yet empirical research on the association between this division and health remains limited. Using three-level hierarchical linear model, we yielded four key findings: (a) The relationship between household labor time and the health index score for both partners exhibited an inverted U-shaped pattern. (b) An increase in the husband’s share of housework may help improve his own health, but both excessive and insufficient participation in housework is closely associated with poorer health outcomes for his wife. (c) Older women’s health is more strongly associated with the traditional division of labor of “men as breadwinner, women as homemaker,” while older men’s participation in paid labor, cohort and region types serve as key moderating factors in the relationship between household labor division and health. (d) Urban older couples exhibit better health under a more equal division of housework, and co-residence with children is linked to better health for older women. Gender equality within the family should be promoted with consideration of China’s traditional cultural context, and policies should safeguard the health rights of vulnerable groups such as women, empty-nest older adults, and rural populations.</p>