Objectives: Sexual and reproductive health (SRH) is vital to personal overall well-being, this study aims to explore the SRH service utilization and its correlates among older people living with HIV (PLHIV) in China. Study design: Cross-sectional study. Methods: We conducted a cross-sectional study to collect data from older PLHIV aged 50 and above in HIV/AIDS treatment hospitals in China. SRH services included reproductive health examination, STI testing, sexual life counseling, and cervical cancer screening. Multivariable logistic regression models were used to analyze the correlates of SRH service utilization (four dichotomous outcome variables). Results: 680 older PLHIV (500 males and 180 females) were enrolled. The mean age was 60.3 +/- 7.8 years. 18.2 % of participants received a reproductive health examination, 9.0 % received STI testing, 36.1 % sought sexual life counseling, and 36.1 % of females had screened for cervical cancer. Females (aOR = 3.26, 95 %CI: 1.89-5.60), those with higher education (2.15, 1.11-4.15), higher income (2.08, 1.24-3.50), and a physical health condition (2.11, 1.14-3.90) were more likely to have received a reproductive health examination. Individuals who were employed (2.05, 1.05-3.97), had a physical health condition (2.91, 1.39-6.00), identified as homosexual (2.17, 1.06-4.47), or reported sexual desire (2.14, 1.01-4.66) were more likely to have received STI testing Living in urban areas (4.33,1.89-9.92), higher education (3.71, 1.20-11.45), depression (4.13, 1.82-9.37), bisexual orientation (2.80, 1.23-6.36), and sexual satisfaction (2.64, 1.22-5.72) were positively significantly associated with seeking sexual life counseling. Those with higher education (5.79, 2.00-16.70), higher income (3.98, 1.24-12.76), and a physical health condition (13.91, 2.89-66.92) were more likely to have screened for cervical cancer. Conclusion: Improving the SRH messages and services tailored for older PLHIV may be conducive to improving their utilization of SRH services.