Aims The aim of this study was to examine the prevalence of psychological distress in survivors 60 years old and older by sex and analyse risk factors for psychological distress in male and female older survivors 2 years after the Wenchuan earthquake. Methods This was a cross‐sectional study. Two hundred fifty‐seven older people were involved and a multistage random sampling method was utilised. Logistic regression analysis was used to determine risk factors for psychological distress among older men and women. Results A higher prevalence of psychological distress was observed in older women than in older men. Loss of family members and displacement from pre‐earthquake residence were significant risk factors for psychological distress in older men. Significant risk factors for psychological distress in older women were lower educational level, chronic diseases, loss of family members, and displacement from original residence. Conclusions Health‐care providers should take sex‐based strategies to improve mental health among older survivors in a long‐term post‐disaster recovery programme.