Based on the Chinese longitudinal healthy longevity survey conducted in 2002, this paper uses hierarchical linear model (HLM) to make an approach to the possible determinants of activities of daily living (ADL) of Chinese oldest old (aged 80 and above) by combining both individual and provincial level factors. The descriptive analysis shows that there is a great differ- ential in ADL by province among Chinese oldest old. The findings turn out that there does exist a significant differential in ADL between oldest old and young old, and that there is also a great differential in ADL by province among Chinese oldest old. The HLM demonstrates that comorbidity, age, cognitive impairment, visual impairment, and emotion could be the most important indi- vidual factors while natural environment, medical facilities, type of staple food and poverty rate in urban areas are the most sig- nificantly regional determinants of ADL of oldest old. The find- ings imply that future actions should not only be taken at individ- ual level, but also at regional level in order to achieve the goal of a healthy aging society in China. Based on the Chinese longitudinal healthy longevity survey conducted in 2002, this paper uses hierarchical linear model (HLM) to make an approach to the possible determinants of activities of daily living (ADL) of Chinese oldest old (aged 80 and above) by combining both individual and provincial level factors. The descriptive analysis shows that there is a great differ- ential in ADL by province among Chinese oldest old. The findings turn out that there does exist a significant differential in ADL between oldest old and young old, and that there is also a great differential in ADL by province among Chinese oldest old. The HLM demonstrates that comorbidity, age, cognitive impairment, visual impairment, and emotion could be the most important indi- vidual factors while natural environment, medical facilities, type of staple food and poverty rate in urban areas are the most sig- nificantly regional determinants of ADL of oldest old. The find- ings imply that future actions should not only be taken at individ- ual level, but also at regional level in order to achieve the goal of a healthy aging society in China.