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Chronic kidney disease (CKD) is an inflammatory disease characterized by the deterioration of renal function, which imposes a significant burden on the healthcare system. In the recent decades, the ageing of the population and the increase of ozone pollution have accelerated. However, epidemiological associations between long-term ozone exposure and renal function in susceptible populations are understudied. In this study, we aimed to investigate the association of 1 y ozone exposure with renal function among the older adults in Xiamen City, China. We recruited 6024 eligible participants with a median age of 65.00 years, estimated their ozone exposure data, and collected questionnaires on demographic status and lifestyle factors as well as information on healthcare access. A generalized linear model was used to assess the association. An increase of 10 μg/m3 of 1 y ozone exposure was negatively associated with the estimated glomerular filtration rate (eGFR) [-3.12 (95% CI: −4.76, −1.48)]. The associations were stronger in men, non-smokers, and those with hypertension or T2DM. Clinical indicators of high-density lipoprotein, low-density lipoprotein, triglycerides, and total cholesterol were the main mediators to regulate the ozone-renal function association. Our results suggested that long-term ozone exposure is a potential risk factor for renal function in Chinese middle-aged and elderly adults. [Display omitted] • Renal function indicated by eGFR level was negatively associated with a 10 mg/m3 increase of 1-year ozone exposure [-3.12 (95% CI : −4.76, −1.48)]. • The ozone-eGFR/renal function associations were stronger among males, non-smokers, and the patients with hypertension or T2DM. • The ozone-eGFR/renal function associations were mainly regulated by high-density lipoprotein, low-density lipoprotein, triglycerides, and total cholesterol. [ABSTRACT FROM AUTHOR]