Objective To understand community-residing older adults′ needs for mutual aid elderly care service, to analyze the relationship between such needs and two-way social support and to provide references for targeted interventions. Methods Using convenience sampling method, 256 elderly people from 3 communities in Hunan Province were selected from June to September 2022. They were surveyed using a general information questionnaire, the Home-Based Mutual Aid Elderly Care Service Scale, and the Brief Tow-Way Social Support Scale. Results The total score of needs for mutual aid elderly care service was (34.86±7.35) points, and the total score of two-way social support was (38.64±4.08) points. A positive correlation between needs for mutual aid elderly care service and two-way social support was found (r=0.398, P<0.05). The results of multiple linear regression analysis showed that the habitation style, exercise frequency, the number of chronic diseases and the score of two-way social support of the community-residing older adults were the main influencing factors of needs for mutual aid elderly care service, explaining 39.8% of the total variation. Conclusion Community-residing older adults have low level of needs for mutual aid elderly care service. Such needs are closely related to individual characteristics and two-way social support of the elderly. It is recommended that community workers take targeted measures to enhance the willingness of the elderly to participate in mutual aid elderly care service, promote the development of such service, in an effort to push forward healthy aging process in China.