Objective To understand the facilitators and barriers of the caregiving relationship between nursing assistants and the elderly from different perspectives, in order to provide references for establishing a family-like caregiving relationship. Method A descriptive qualitative study was designed, from July to September 2023, purposive sampling was used to select 4 nursing managers,32 older adults and 56 nursing assistants from 9 nursing homes across 6 cities to conduct face-to-face semi-structured in-depth interviews or focus group interviews. The interview data were analyzed using thematic analysis. Results The facilitators of the relationship between nursing assistants and the elderly included the fulfillment of the older adults′ needs, the personal traits of the nursing assistants, social support, and reciprocal relationships. The barriers included imbalance in resource allocation, cultural conflicts, inconsistency within the family, and insufficient support. Conclusion It is important to focus on the positive facilitators at the individual level of nursing assistants, as well as the family and social support levels in fostering a healthy caregiving relationship between nursing assistants and the elderly. Efforts should be made to actively address the negative barriers in the development of this relationship, in order to help establish a good caregiving relationship between nursing assistants and the elderly.