Background: First marriage was vital for a common person in all-life, and there were concerns that marital quality had relationship with self-reported health and quality of life (SRH and SRQoL), health change, and sleep quality. This study aimed to examine longitudinal associations between subjective health assessment and quality of first marriage to characterize the stability and directionality of the trajectory of marriage- health over time.Methods: Data were from the Chinese Longitudinal Healthy Longevity Survey. Chinese elders completed surveys across 3 waves (2008/2009, 2011/2012, and 2014). Using autoregressive cross-lagged models, bidirectional relationships between SRH, SRQoL, health change, sleep quality, and quality of first marriage over time were examined.Results: Cross-sectional analysis confirmed the significant associations between SRH, SRQoL, health change, sleep quality, and quality of first marriage. Autoregressive linear models of SRH, SRQoL, health change, sleep quality, and quality of first marriage were confirmed. Cross-lagged relationship between SRQoL and SRH, between SRQoL and sleep quality, between SRQoL and health change, between SRH and sleep quality, between quality of first marriage and SRQoL, and between sleep quality and health change were confirmed. Conclusions: Subjective health assessment was associated with future subjective health assessment across 3 longitudinal waves. Quality of first marriage might be influenced by SRQoL among older Chinese. Future research needs to examine influencing psychological mechanism of the cross-lagged relationships.