Bullying victimization is associated with adverse mental health consequences, while bullies suffer few or no adverse consequences in Western societies. Yet the universality of these consequences across western and eastern cultures is unknown. The current study investigated retrospective bullying experience in primary and secondary schools and its effects on adult mental health (depression, anxiety, stress, lifetime suicidal behavior, positive mental health, life satisfaction, social support, self-efficacy, and sense of control) in 5,012 Chinese and 1,935 German university students. School bullying victimization was far less frequently recalled by the Chinese sample (6.2%–12.6%) than the German sample (29.3%–37.0%), but victims had similar adverse mental health in both countries. In Germany, bullies and not-involved had equally good mental health, whereas bullies in China had poor mental health comparable to victims. Bullying victimization has similar adverse effects on mental health across countries. However, compared to the German students, the prevalence of school bullying is significantly lower, and bullies are also more likely to suffer mental health problems in adulthood in Chinese students. The differences of reasons for and consequences of being bullies are discussed and may have important implications for evolutionary theories and interventions of bullying.