Abstract: With the population aging in China, health and health inequality of the elderly are the focus of attention to achieve common prosperity and social equity. Using the latest data of China health and pension tracking survey (CHARLS) released in 2020, this paper first explores influencing factors of the health of the elderly, then uses the centralized index method to measure health inequality of the elderly in China, decomposes the centralized index, and explores the contribution rate of different factors to health inequality. The results show that: 1) the health inequality index of the elderly in China has reached 7.941%, and there is significant health inequality between the elderly and the high-income group; 2) income, education level, gender, urban and rural registered household registration and the eastern region have a significant impact on health and health inequality of the elderly, but the impact direction of health inequality is different; 3) intergenerational economic support, age, recent medical visits, hospitalization status in the past year, central region, number of chronic diseases, and health insurance contribute less to health inequality. The following are several important paths to achieve health equity on the road of common prosperity: perfecting income distribution mechanism, promoting coordinated development of urban and rural regional economies and equalization of compulsory education, protecting the rights and interests of workers, and improving the level of medical and health services and the elderly security.