OBJECTIVES: We investigated the characteristics of the oldest old in China and examined whether the factors associated with longevity varied with advanced age. METHODS: Drawing from the largest nationally representative longitudinal sample of oldest-old adults, we stratified descriptive statistics separately by gender and urban-rural residence and then used ordered logit models to examine the multivariate factors associated with increasing age-group membership. RESULTS: Differing combinations of demographic, social, physical, and behavioral factors were significantly related to surviving into later ages for men and women in urban and rural areas. With the exception of rural women, psychological disposition was not associated with increased longevity. Gender differences were generally smaller in urban areas than in rural areas, and urban-rural differences were more pronounced among women than among men. CONCLUSIONS: Findings from the oldest-old population in China challenge many of the established relations in the health-inequality literature. Future research should examine why the oldest old are an exceptional group of physically, socially, and demographically heterogeneous individuals who exhibit healthy longevity beyond the average life span.