Objective: To explore the factors affecting balance ability among middle-aged and elderly people with depressive symptoms, so as to provide the evidence for improving balance ability and prevention of falls. Methods: Based on the 2015 database of China Health and Retirement Longitudinal Study (CHARLS), demographic information, lifestyle and health status were collected from people aged 45 years and older who scored 10 and more on the Self-rating Depression Scale or took antidepressants. The balance ability was assessed by semi-tandem and full-tandem stand tests, which was defined as meeting the standard when both tests were completed. Factors affecting the balance ability among middle-aged and elderly people with depressive symptoms were identified using a multivariable logistic regression model. Results: Data were collected from 4 263 participants with an mean age of (60.73±8.53) years, including 1 748 males (41.00%) and 2 515 females (59.00%). There were 1 241 people failed to meet the standard of balance ability test, accounting for 29.11%. Multivariable logistic regression analysis showed that participants who were at ages of 65 years and older (OR=1.234, 95%CI: 1.071-1.421), were female (OR=1.422, 95%CI: 1.161-1.741), were physically disabled (OR=1.309, 95%CI: 1.127-1.521) and had physical pain (OR=1.170, 95%CI: 1.023-1.340) had higher risks of failing to meet the standard of balance ability test, while participants who took naps (OR=0.856, 95%CI: 0.748-0.980), never smoked (OR=0.641, 95%CI: 0.517-0.793) and had social activities (OR=0.864, 95%CI: 0.755-0.988) had lower risks of failing to meet the standard of balance ability test. Conclusion The balance ability among middle-aged and elderly people with depressive symptoms was associated with age, gender, napping, smoking, social activities, physical disability and physical pain.