BACKGROUND: Chronic diseases among older adults are recognised as a serious public health problem in China, causing rising social and economic burden. The aim of the study was to evaluate the association between chronic diseases and lifestyle risk factors among community-dwelling older adults who attended community health service centres (CHSC) in Southern China. METHODS: A retrospective cross-sectional study ( RESULTS: There were 361 cases [mean age 74.65 (SD = 5.61) years] included in the sample (from total registry records CONCLUSION: Data collected via medical examination identified the top five chronic diseases among older adults of Guangzhou city, China. Lifestyle risk factors are significantly associated with chronic diseases. Findings from the study will inform future design and evaluation of targeted, new services for these older adults. Further research to evaluate lifestyle interventions that can improve the health of older adults living with chronic disease is required. TRIAL REGISTRATION: Ethical approval ([2022]02-014-01) was obtained from the Health Research Ethics Committee of the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. The study was registered on the Chinese Clinical Trial Registry Centre (registry number: ChiCTR2200066750).