OBJECTIVES: Motor cognitive risk (MCR) syndrome, defined as the cooccurrence of subjective cognitive complaints and a slow gait speed, is a form of pre-dementia condition. Balance has previously been associated with cognitive function. However, to date, no study has examined the relationship between balance and MCR in a large cohort of older adults. We aimed to investigate the associations of balance with MCR among Chinese older adults. RESEARCH DESIGN AND METHODS: Data from the wave 1 to wave 3 of the China Health and Retirement Longitudinal Study (CHARLS) were used. Balance was measured using validated tandem stance. Logistic and discrete-time survival cox regression analyses were performed to examine the relationship between baseline balance impairment and prevalent and incident MCR. RESULTS: A total of 3,398 participants were included in the baseline study. The prevalence of balance impairment was 21.1%. In the cross-sectional analysis, balance impairment was significantly associated with higher odds of MCR in the fully-adjusted model (OR: 1.43 95%CI 1.14-1.80, p = 0.002). A total of 2,474 individuals were included in the longitudinal analysis. During a mean follow-up duration of 3.69 years, the incidence of MCR was 9.8%. Baseline balance impairment was also significantly related to incidence of MCR (HR:1.37 95%CI 1.03-1.82, p = 0.032) even adjusting all confounders. CONCLUSION: These results show that early recognition of balance disorder may be helpful in the prevention and treatment of cognitive decline in older adults.