Some studies have indicated that the consumption of chilli-containing foods can influence iron absorption and affect serum insulin and glucose concentrations, which may help to alleviate diabetes or prediabetes. The objective of this study was to explore the relationship between chilli food habits with iron status and insulin resistance in the Chinese population. Fasting blood samples, anthropometric data, and chilli food habit data collected from 8433 adults (aged 18 to 99), in 2009, as part of the China Health and Nutrition Survey, a large-scale longitudinal, household-based survey in China. Chilli food habits were assessed using chilli food eating frequencies (no eating, sometimes eating, often eating, and usually eating) and chilli food types (a little bit hot, moderately hot, and very hot). Fasting serum ferritin, insulin, and fasting plasma glucose were also measured. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to estimate insulin resistance. Compared with the chilli-eating group, the no eating group had higher HOMA-IR levels for both men and women (P<.05). There were significant differences in HOMA-IR (P<.05) for both men and women and in ferritin (P<.001) for women according to different chilli food types. However, there was no significant difference in the ferritin level and HOMA-IR components for different chilli food eating frequencies in both sex groups. Chilli food habits, especially the different hotness levels of chilli food, were associated with iron status and insulin resistance in the Chinese population. Additional studies are needed to elucidate mechanisms of action and to establish causal inference.