Objective: To investigate the level of chronic disease prevention and control literacy and its influencing factors among residents in Taizhou City, Zhejiang Province, so as to provide insights into formulating health education strategies on chronic diseases. Methods: A total of 32 313 permanent residents at ages of 15 to 69 years were sampled in Taizhou City using the multi-stage stratified random sampling method and probability proportionate to size sampling method (PPS). Subjects' demographic characteristics and chronic disease prevention and control literacy were collected using the national health literacy surveillance questionnaire. The levels of chronic disease prevention and control literacy from 2017 to 2022 were evaluated and standardized by the population data provided by Taizhou Municipal Bureau of Statistics. Factors affecting the chronic disease prevention and control literacy were identified using a multivariable logistic regression model. Results: Totally 32 313 questionnaires were distributed, and 32 258 valid questionnaires were recovered, with an effective recovery rate of 99.83%. The median age of participants was 51.00 (interquartile range, 19.00) years. There were 15 754 men (48.84%) and 16 504 women (51.16%), and 11 060 urban residents (34.29%) and 21 198 rural residents (65.71%). Farmer was the predominant occupation (16 003 residents, 49.61%). The level of chronic disease prevention and control literacy among residents in Taizhou City was 32.97%, which was 22.58%, 26.41%, 33.48%, 34.44%, 38.53% and 39.68% from 2017 to 2022, respectively, showing an upward trend (P<0.05) with a cumulative growth rate of 17.10%. Multivariable logistic regression analysis showed that age (15 to 24 years, OR=1.566, 95%CI: 1.309-1.874; 25 to 34 years, OR=1.345, 95%CI: 1.173-1.542; 35 to 44 years, OR=1.482, 95%CI: 1.311-1.675; 45 to 54 years, OR=1.203, 95%CI: 1.078-1.343), educational level (primary school, OR=1.728, 95%CI: 1.546-1.932; junior high school, OR=2.211, 95%CI: 1.977-2.472; high school/vocational high school/technical secondary school, OR=3.368, 95%CI: 2.972-3.817; college or above, OR=7.271, 95%CI: 6.313-8.373), occupation (farmer, OR=0.739, 95%CI: 0.663-0.825; others, OR=0.778, 95%CI: 0.694-0.872), place of residence (urban areas, OR=0.903, 95%CI: 0.852-0.956) and annual household income (30 000 to 49 999 Yuan, OR=1.138, 95%CI: 1.030-1.259; 50 000 to 99 999 Yuan, OR=1.239, 95%CI: 1.143-1.342; 100 000 to 199 999 Yuan, OR=1.445, 95%CI: 1.334-1.566; 200 000 Yuan and above, OR=1.803, 95%CI: 1.629-1.997) were influencing factors for chronic disease prevention and control literacy. Conclusions The level of chronic disease prevention and control literacy among residents in Taizhou City shows an upward trend from 2017 to 2022, with age, educational level, occupation, place of residence and annual household income as the influencing factors.