Objective To investigate the current status of proactive health behavior ability among disabled elderly in nursing homes, and to analyze its influencing factors. Methods From March to June 2024, 325 disabled elderly were conveniently selected from 15 nursing homes in Sichuan Province and Chongqing Municipality, then they were investigated by using a general information questionnaire, the Satisfaction with Life Scale, and the Assessment Scale of Proactive Health Behavior Ability for the Disabled Elderly in Nursing Homes. Results The participants′mean score of proactive health behavior ability was (95.77±18.80) points. Multivariate linear regression analysis revealed that, monthly household income, degree of disability, knowledge of proactive health-related information, frequency of seeking treatment during previous illnesses, frequency of avoiding health-risk behaviors, frequency of actively addressing life stress events, frequency of caregiver-provided care on demand, frequency of participation in health-related activities at the care facility, and life satisfaction were the primary factors influencing the proactive health behavior ability of disabled elderly in nursing homes (all P<0.05). Conclusion The proactive health behavior ability of disabled elderly in nursing homes is at a moderate and above level. Nursing homes and caregivers should implement targeted interventions according to the influencing factors to enhance the proactive health behavior ability of disabled elderly.