Objective To explore the relationship between health literacy （HL）,empowerment and quality of life （QOL） in disabled elderly and their spouses based on the theory of “dyadic coping”. Methods From December 2020 to June 2021,498 disabled elderly and their spouses in Guangzhou,Zhuhai and Shenzhen of Guangdong province were surveyed by sociological data questionnaire,Katz Index ADL Scale,Health literacy Scale for chronic disease patients,Chinese Elders Health Empowerment Scale and Chinese Short Form-36 Health Survey. Spearman correlation analysis and structural equation model were used to analyze the data. Results The median scores of HL,empowerment and QOL of the disabled elderly were 86.00,30.00 and 391.39,respectively. The median scores of HL,empowerment and QOL of the spouses were 93.00,32.00 and 617.28,respectively. Correlation analysis showed that there were positive correlations between all variables（r=0.156~0.657,P<0.05）,except correlation between spouses’ empowerment and QOL of the disabled elders（P=0.91）. The structural equation model showed that the HL of the disabled elderly could affect the QOL directly or indirectly through empowerment （path coefficients were 0.30 and 0.23,P<0.001）,and the model fitted well（GFI=0.811,AGFI=0.788,RMSEA=0.057）. The HL of the disabled elders and their spouses had a positive interaction（path coefficient was 0.47,P<0.001）. The QOL of the disabled elders was positively correlated with the QOL of their spouses（path coefficient was 0.18,P=0.004）. Conclusion The interaction of HL and QOL between the disabled elders and their spouses suggests that the disabled elders and their spouses should not be considered separately under the pressure of disability,which verifies the rationality of the application of “dyadic coping” theory. The disabled elders and their spouses should be educated and empowered together to improve their QOL.