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This study examined the influence of lifestyle habits on health self-assessments among elderly rural men and the effect of age on the strength of the impact to provide a basis for targeted health improvement in this population. Data from the 2018 Chinese longitudinal healthy longevity survey were analyzed using one-way analysis of variance, regression analysis, and Shapley value decomposition tests. The model analysis results showed that elderly rural men who did not drink alcohol or were moderate drinkers, maintained regular sleep patterns, exercised regularly, and had active social interactions had better health self-assessment results (p < 0.01). Notably, the impact of lifestyle habits on health perceptions varied with age. Specifically, the influence of alcohol consumption and sleep duration decreased with age, while the benefits of physical activity and social engagement became more pronounced. These results suggest that lifestyle habits significantly impact the health self-assessments of elderly rural men, with notable variations observed in the strength of these effects across different ages. To improve the overall health of elderly rural men, alcohol cessation interventions should be implemented as early as possible, attention should be paid to the sleep habits of young male seniors, and low-intensity group exercise and social activities should be actively organized for older male seniors.