Normative distribution of serum cystatin C and relationship with sex and age in healthy adult Chinese population is unknown. This is a prospective cohort study. Adult subjects (18years of age and older) who underwent annual health examination at the Health Management Center in Sir Run Run Hospital were eligible. Subjects with major diseases, e.g., hypertension, diabetes, chronic kidney disease, obesity (body mass index ≥ 28kg/m2) were excluded from the analysis. Multivariate logistic regression analysis was conducted to identify risk factors of elevated cystatin C (> 1.03mg/L). Data are shown as median and 95% confidence interval (CI). The final analysis included a total of 10,640 subjects (40 ± 12years, 52% men). The median serum cystatin C concentration was 0.73mg/L (95% CI 0.52-1.03mg/L) in the overall analysis, 0.79 (95% CI 0.59-1.07mg/L) in men, and 0.67 (95% CI 0.49-0.95mg/L) in women. In the multivariate regression analysis, elevated cystatin C was independently associated with the male sex (odds ratio 1.94; 95% CI 1.07-3.52), older age (odds ratio 1.04 every year; 95% CI 1.02-1.06), higher body mass index (odds ratio 1.70; 95% CI 1.01-2.83), uric acid (odds ratio 1.00; 95% CI 1.00-1.01), and β2-microglobulin (odds ratio 39.35; 95% CI 22.90-67.64). The median serum cystatin C concentration was 0.73 (95% CI 0.52-1.03mg/L) in healthy adult Chinese population, 0.79 (95% CI 0.59-1.07mg/L) in men, and 0.67 (95% CI 0.49-0.95mg/L) in women. Elevated cystatin C was associated with the male sex, older age and higher body mass index.