Abstract: ObjectiveTo understand the perception of gender role and familial affair decision making among rural married women and its impact on the utilization of prenatal care.MethodsIn project counties of Anhui and Xinjiang regions,random cluster sampling was used to select study population and face-to-face interview was carried out.ResultsThere were 65.7% of the women got less than 19 scores when answered questions about perception of gender role,and There were 65.7% of the women got less than 19 scores when answered questions about perception of gender role,and 79.3% of the women got less than 18 scores on questions about the decision-making regarding family affairs.The women was subordinate to men in family affairs.The total coverage rate of antenatal care was 55.7% and 64.0% of the women who received antenatal care got the first antenatal visit during the first trimester.The proportion of women who had at least five antenatal visits was 34 3%.The institutional delivery was 55.1% among all women.Perception of gender role,familial affair decision making and education level were predictors for utilization of antenatal care and in stitutional delivery.ConclusionThe raral women's perception of gender role and the decision making on family affair are weak in Xinjiang and Anhui, as well as the prenatal care utilization.