This study explored patterns of service use and associated socioeconomic factors among Chinese elders with mental disabilities. Data from the second China National Sample Survey on Disability (CNSSD) were used in this study. Univariate and multivariate logistic regression models were used to calculate the odds ratios and 95% confidence intervals for factors associated with utilization of mental health services among Chinese elderly people with a mental disability. Among elderly people with a mental disability in the CNSSD, 46.35% had used mental health services. Urban residence, higher education level, being married, medical insurance coverage, and higher annual family income per capita were associated with more utilization of mental health services. This study revealed a low level of mental health service utilization among the Chinese population with mental disorders or a mental disability. Strategies to improve the insurance coverage of mental healthcare, to increase public awareness of mental disorders, and to reduce regional inequality of mental health resources are warranted.