A substantial body of research has explored the relationship between inequality and health, yet little is known about the gender-specific effects and pathways through which inequality affects health outcomes. This study focuses on China, a country characterized by high income inequality and uneven health distribution across social groups. In Study 1, repeated nationally representative cross-sectional data from the Chinese General Social Survey is utilized (N = 3798 for 2017, N = 1578 for 2015, and N = 2827 for 2008), revealing that perceived inequality negatively affects self-rated health, particularly among women. The high level of perceived economic inequality substantially contributes to the gender health gap in China. Study 2 employs a randomized experiment (N = 3568) to show that perceived inequality affects the health of women and men differently, that is, social mobility framing accounts for the negative effect on women’s mental well-being, whereas reducing status anxiety mainly benefits men’s mental health. To advance research on economic inequality and health, this study investigates gender differences in whether and how perceived inequality affects health.