Abstract: Objective To explore the health service demand and utilization among the residents with the New Rural Cooperative Medical and Health Service(NRCMHS). Methods Multi-stage random sampling method was used to selecte 9 740 rural residents from 2 430 families for a face-to-face interview.The data was cleaned and analyzed by using SAS 8.1 softw are. Results The overall two-week disease prevalence of the residents was lower(13.53%)compared to that of national level and was significantly different among the residents in different counties and age groups.The two-week consultation rate was significantly different among the the residents in different counties(P<0.05).The major reason for non consultation within two weeks in the residents with illness was financial difficulties.The proportion of the patients not hospitalized for essential hospitalization treatment(79.22%)was significantly higher than that of the national level and was significantly different among the residents in different counties and with different familial economic condition. Conclusion The New Rural Cooperative Medical and Health Service needs and clinic utilization among the rural residents in Heilongjiang province was better than those of the national level,but hospitalization service utilization was significantly lower than that of the national level and related with the financial condition of the rural residents.