Objective To investigate the longitudinal association between preschool auditory processing and reading-related abilities in early elementary school children (Grades 1-2). Methods A longitudinal design was used. Children (n=107) were randomly sampled from the August 2021 normative study of the Preschool Auditory Processing Assessment Scale (PAPAS) in Nanjing and were re-assessed two years later. Reading-related abilities were evaluated using the Rapid Automatized Naming and Rapid Alternating Stimulus tests (RAN/RAS), the Children's Phonological Awareness Assessment Scale, and the item bank of the Primary School Students' Chinese Character Recognition Test. Cognitive ability and attention were measured with the Wechsler Intelligence Scale for Children and the Integrated Visual and Auditory Continuous Performance Test. Associations between PAPAS and reading-related abilities were examined with correlation analyses and multiple linear regression. Results Eighty-five children completed the follow-up. Children cared for by parents scored higher on the phonological awareness accuracy factor than those cared for by grandparents (P<0.05), and children with music training showed greater literacy than those without (P<0.05). Object naming time on the RAN/RAS was positively correlated with the auditory decoding score (r_s=0.223, P<0.05). The accuracy of initial consonant awareness was negatively correlated with the PAPAS total score (r_s=-0.313), auditory decoding (r_s=-0.262), auditory attention (r_s=-0.227), communication (r_s=-0.310), and visual attention (r_s =-0.367) (all P<0.05). In multiple linear regression adjusting for cognitive ability and attention, auditory decoding was positively associated with object naming time (β=0.264) and negatively associated with the accuracy of final (yunmu) awareness (β=-0.277); hyperactivity/impulsivity was negatively associated with the accuracy of initial consonant awareness (β=-0.311); and visual attention was negatively associated with tone awareness accuracy (β=-0.271) (all P<0.05). In addition, visual attention (β=-0.214) and risk of auditory processing abnormality (β=-0.200) were negatively associated with literacy (P<0.05). Conclusions Preschool auditory processing shows a longitudinal association with reading-related abilities in early elementary school children, and PAPAS has potential clinical value in the early identification of children at high risk of dyslexia.