Given the rapidly aging population and the changes in traditional family bonds, new challenges arise for filial piety in the loneliness among older adults with multiple long-term conditions (MLTCs). This study aimed to examine the PRFP-loneliness relationship, explore whether resilience mediates the association between PRFP and loneliness, and investigate whether cognitive function moderates the indirect or direct effects of the mediation model among Chinese older adults with MLTCs. A total of 635 older adults with MLTCs were recruited in Shenyang City, China. Participants completed self-report questionnaires on PRFP, resilience, loneliness and cognitive function. A moderated mediation model was conducted using Hayes' PROCESS macro for SPSS. PRFP had a significant negative effect on loneliness and resilience partially mediated the PRFP-loneliness relationship. Cognitive function moderated the indirect effect of PRFP on loneliness via resilience. Specifically, the conditional indirect effect of PRFP on loneliness diminished as the level of impaired cognitive function increased. Interventions aimed to improving resilience and cognitive function may help strengthen the link between PRFP and loneliness among older adults with MLTCs. However, we should suggest a cautious application of this research when translated to the geographic and cultural diversity of older adults.