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Objective: To evaluate the association between triglyceride glucose (TyG) index and its novel composite metabolic indexes combined with obesity-related indexes and cardiovascular disease (CVD) risk in middle-aged and old adults in China. Methods: Based on data from the China Health and Retirement Longitudinal Study from 2011 to 2020, a study was conducted in 6 158 middle-aged and old adults without CVD at baseline survey. Cox proportional hazard regression model was used to assess the association of each indicator with the risk for CVD. Kaplan-Meier curve and restricted cubic spline (RCS) were also used to explore the dose-response relationship and nonlinear trends. Subgroup analyses were used to test the stability of the association in people with different demographic characteristics. Results: A total of 1 639 CVD events occurred during the 9-year follow-up period. After adjusting for confounding factors, high levels of TyG index and its combined obesity index were significantly associated with an increased risk for CVD. Compared with the Q₁ group, the HRs (95%CIs) of TyG, TyG-BMI, TyG-waist-to-height ratio (WHtR), and TyG-weight-adjusted-waist index (WWI) were 1.36 (95%CI: 1.19-1.57), 1.74 (95%CI: 1.51-2.01), 1.55 (95%CI: 1.34-1.79), and 1.38 (95%CI: 1.20-1.60) in the Q₄ group, respectively. RCS analysis showed that TyG and TyG-BMI had linear association with the risk for CVD, whereas TyG-WHtR and TyG-WWI had non-linear association with the risk for CVD. Subgroup analyses suggested that the associations were in good agreement in people in different age, sex, education level and hypertension status group (all P for interaction >0.05). Conclusions: The TyG index combined with obesity index is significantly associated with the risk for CVD in middle-aged and old adults in China. Paying attention to the TyG index and obesity index in the middle-aged and old adults can benefit the prevention and treatment of CVD and other chronic diseases in the elderly in China.