Based on data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), a moderated mediating model was established to investigate the mediating effect of social engagement on hearing status and depression, and whether the mediating effect was moderated by family emotional support. The results showed that: (1) Compared with the elderly without hearing impairment, the level of depression in the elderly with hearing impairment was relatively higher (b = 0.0820, p<0.001); (2) Social engagement played a partial mediating role in the relationship between hearing status and depression, The proportion of mediating effect was 10.24%; (3) The relationship between hearing status and social participation was moderated by family emotional support (b = -0.0554, p<0.001). The higher the family emotional support, the lower the social participation of the elderly with hearing impairment, and the higher the social participation of the elderly without hearing impairment; (4) Family emotional support moderated the mediating effect of social participation on the relationship between hearing status and depression (Index = 0.0048, confidence interval = [0.0017, 0.0082]). Therefore, when the hearing loss of the elderly is found, it should be timely intervention; For families with high emotional support, attention should be paid to patiently enlightening and comforting the elderly with hearing impairment, giving them positive psychological support, encouraging them to go out of their homes and participate in more social activities to avoid the occurrence of depression symptoms.