Adverse childhood experiences (ACEs) are linked to poor health outcomes. However, research connecting a broader personality framework with ACEs and health outcomes remains limited. This study examined associations between cumulative ACEs, HEXACOD personality traits—a seven-factor extension of the HEXACO framework, including Disintegration, a trait reflecting proneness to psychotic-like experiences and behaviors—and health outcomes in a nationally representative Serbian sample ( N  = 2,721). Using multi-group structural equation modeling, we examined the simultaneous contributions of personality and cumulative ACEs to predict mental and physical health. Measurement invariance analyses supported scalar invariance across gender groups. Disintegration emerged as the most robust predictor of poor mental and physical health, followed by high Emotionality and low eXtraversion. Although ACEs were significantly associated with both health domains, their predictive power was smaller than that of Disintegration. These findings underscore the role of Disintegration as a broad dispositional vulnerability with early adversity in relation to adult health outcomes. More generally, the findings suggest that personality profiles may shape how adversity is experienced and reported.