Objective To describe the level of health care needs of the elderly with chronic diseases in Guangxi and to explore the related factors, thus to provide reference for targeted intervention. Methods By using convenient sampling and quota sampling, communitydwelling elderly people were selected from Nanning, Guilin and Guiping city of Guangxi to receive questionnaire survey in terms of their health care needs. Results A total of 1 032 participants completed the survey, of whom 805 had chronic diseases, accounting for 78.0%. The total average score of health care needs and subscale scores of physical, mental and living environment in the elderly with chronic diseases were significantly higher compared to those without chronic diseases （P＜0.01 for all）. Multiple linear regression analysis showed that the number of chronic diseases, monthly income, and ADL score were the main influencing factors of health care needs of the elderly people with chronic diseases （P＜0.01 for all）. Conclusion The health care needs of the elderly with chronic diseases are diversified and influenced by multiple factors. In order to meet their needs and improve their quality of life, we should consider actual resources and situations of Guangxi, provide multipath and individualized service, improve their living environment and change their attitude toward health.