Background <p>This study aimed to understand the health empowerment status of rural disabled older people and analyse the influencing factors to provide a reference for targeted intervention measures.</p> Methods <p>A cross-sectional survey was conducted using cluster sampling in natural administrative villages (the cluster units) involving 208 disabled older individuals from a rural community in Henan Province. The empowerment level was measured using a chronic disease empowerment scale containing five dimensions and 23 items (score 23–115). Variables were screened by the least absolute shrinkage and selection operator (LASSO) method (<i>λ</i> = 0.0529); their relative importance was ranked with the random forest algorithm. Multiple regression analysis was conducted to determine the significant predictors.</p> Results <p>The overall empowerment score for rural disabled older people was moderate (mean 2.42 ± 0.53 on a 5-point Likert scale, 48th percentile). The LASSO analysis identified education, age, main economic source, monthly income, monthly medical expenses, degree of disability, number of chronic diseases, number of children and marital status as the top nine influential factors. Multiple regression analysis revealed that the number of children, type of chronic diseases, education level and degree of disability affected the empowerment level of rural disabled older individuals (<i>p</i> &lt; 0.05).</p> Conclusions <p>The current situation of empowerment of disabled older people in rural areas is at the middle level, especially in the aspects of self-decision, health records and smart pensions. Empowerment can be implemented through the following: (1) village doctor health education programmes; (2) caregiver skills training; (3) county-level disability/chronic disease joint follow-up systems.</p>