BACKGROUND: Osteoarthritis (OA) is closely linked to cardiovascular diseases, mainly afflicting older adults. Our study aims to explore the association between Life’s Essential 8 (LE8), a newly developed measurement of cardiovascular health (CVH), and OA in the middle-aged and elderly population. METHODS: Our study utilized data from the National Health and Nutrition Examination Survey 2007–2018. OA was ascertained by self-reported data from questionnaires. The overall LE8 score is calculated as the mean of 8 individual metric scores ranging from 0 to 100 and is categorized into three CVH levels: low (0–49), moderate (50–79), and high (80–100). Multivariate logistic and restricted cubic spline regression models were performed to explore the associations between CVH and OA. Subgroup and sensitivity analyses were conducted to test the robustness of main results. RESULTS: Our study included 10,231 participants aged ≥ 40 years from NHANES. The total age-adjusted prevalence of OA was 22.4%. After adjusting for the potential covariates, the adjusted odds ratio (AOR) of OA was significantly lower in participants with a moderate level (AOR = 0.687, 95% CI: 0.531, 0.889) or high CVH level (AOR = 0.430, 95% CI: 0.326, 0.567) compared to those with a low CVH level. Similar trends in the associations of the health behavior score and health factor score with OA were also observed. CONCLUSIONS: LE8-evaluated CVH levels were inversely associated with OA risks in the middle-aged and elderly U.S. population, indicating that maintaining the optimal CVH level may potentially contribute to the management of OA risks. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-025-08781-y.