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This study examined the longitudinal association of depressive symptoms with grandchild care intensity and whether the association varies by household structure, residential area, and gender for Chinese grandparents. Using data from three waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011–2015), we applied multilevel mixed effects models to examine changes in depressive symptoms and the associations with caregiving intensity and to test the moderation effects of residence, living arrangement, and gender. After controlling for sociodemographic and health covariates, we found that providing a medium level of grandchild care was associated with fewer baseline depressive symptoms compared with non-caregivers. Providing low-level care among those living with spouse/partner and among those living with child(ren)/others was associated with fewer depressive symptoms relative to non-caregivers with similar living arrangements. Findings indicate that a medium level of involvement in childcare was associated with better mental wellness and low levels of caregiving may benefit nonresidential caregivers. More prospective longitudinal studies are needed to improve the operationalization of grandparent caregiving, validate the associated health outcomes, and apply a contextual approach to examine socioeconomic, cultural, and policy-related contexts of caregiving in the changing world of China. [ABSTRACT FROM AUTHOR]