Objective To analysis the status and influencing factors of health literacy among elderly individuals aged 60-69 in poverty-alleviated areas of Anhui Province, and to provide a basis for formulating targeted health education policies and measures for the elderly in these areas. Methods Stratified multi-stage probability proportional to size sampling was used to select the elderly aged 60-69 in poverty-alleviated areas of Anhui Province in 2024. Household surveys were carried out with the National Resident Health Literacy Monitoring Questionnaire, and multi-level on-site quality control was implemented. Chi-square test and multivariate logistic regression analysis were performed on weighted monitoring data to investigate the current status and relevant influencing factors of health literacy in this population. Results The overall health literacy level of the surveyed population was 10.91%. The health literacy levels in the three dimensions were as follows: basic knowledge and concepts, 16.99%; healthy lifestyles and behaviors, 15.15%; and basic skills, 13.67%. The literacy levels for the six categories of health issues in descending order were: safety and first aid (33.82%), scientific health perspectives (32.22%), health information (26.45%), chronic disease prevention (18.94%), basic medical care (17.47%), and infectious disease prevention (11.72%). Multivariable logistic regression analysis showed that, compared to the 60-64 age group and the never smoking group, the 65-69 age group (OR=0.684, 95%CI: 0.485-0.966) and the smoking group (OR=0.605, 95%CI: 0.380-0.962) were associated with lower health literacy levels, Using illiteracy or minimal literacy as the reference, whereas participants with primary school education (OR=3.313, 95%CI: 1.970-5.572), junior high school education (OR=3.959, 95%CI: 2.330-6.729), and senior high school or above (OR=13.919, 95%CI: 7.720-25.094) were associated with higher health literacy levels. Conclusion The health literacy level among elderly individuals aged 60-69 in poverty-alleviated areas of Anhui Province was relatively low. Targeted health education should focus on those with low educational attainment, smoking and those aged 65-69, with particular emphasis on strengthening education on chronic disease prevention and control, basic medical care, and infectious disease prevention and control, in order to improve basic health skills.