ObjectivesFew data on the association between housing structure and depression among rural elders in China are available. We examined the impact of built forms on depression.DesignThis is a cross-sectional study.SettingA representative sample of rural residents aged 60 years or older in China.ParticipantsA total of 5090 older adults in 2019 in rural Suzhou, China.Outcome measuresAssociations of built form with odds of probable and possible depression.ResultsThere was significant difference among elders living in varied sizes of house. Older age (vs 60–64 years: 75–79 years AdjOR, 1.737; 95% CI, 1.309 to 2.305; ≥80 years AdjOR, 2.072; 95% CI, 1.439 to 2.981), male sex (AdjOR, 0.719; 95% CI, 0.593 to 0.871), single (AdjOR, 1.303; 95% CI, 1.032 to 1.646), self-care disability (AdjOR, 4.761; 95% CI, 3.960 to 5.724), three or more chronic diseases (AdjOR, 2.200; 95% CI, 1.657 to 2.920), living alone (AdjOR, 1.443; 95% CI, 1.059 to 1.966), living in cottage (AdjOR, 1.426; 95% CI, 1.033 to 1.967), living space (vs <50 m2: 201–250 m2 AdjOR, 0.566; 95% CI, 0.359 to 0.893; >250 m2 AdjOR, 0.337; 95% CI, 0.223 to 0.511) and space per person (vs <30 m2: 30- m2 AdjOR, 0.502; 95% CI, 0.362 to 0.697; 40- m2 AdjOR, 0.473; 95% CI, 0.347 to 0.646; 50- m2 AdjOR, 0.418; 95% CI, 0.339 to 0.515) were associated with risk of depression among Chinese rural elders.ConclusionThe built form was significantly and meaningfully associated with depression among Chinese rural elders. More attention should be paid to preventing mental illness among the rural elderly living in the small housing area and cottages in China.