Abstract: Objective To explore factors influencing the participation in the New Rural Cooperative Medical System(NRCMS)among rural residents in Heilongjiang province.Methods Totally 9 207 rural residents were selected through stratified sampling from 9 counties in Heilongjiang province and surveyed with a household interview.The data collected were statistically analyzed.Results For the residents surveyed,9 207(94.5%) participated in the NRCMS;1 525(15.7%)knew about the essential drug list of the NRCMS;7 260 (74.5%)knew about the annual amount of personal fund for the NRCMS;and 6 254(64.2%)knew the premium standard of NRCMS.The number of the residents satisfying or very satisfying with the individual contribution accounted for 40.7%.Among the participants of the NRCMS,23.4% were either satisfied or very satisfied with the medical facilities covered by the NRCMS.Multivariate analyses demonstrated that factors influencing the participation in NRCMS among the residents were educational level (odds ratioOR=0.630),income (OR=1.323),the cost of medical care during previous one year (OR=2.027),whether with a medical facility at a distance within 15 minutes away from home(OR=0.474),whether knowing about the self-paid annual amount of premium for the NRCMS(OR=0.313),the premium standard of the NRCMS(OR=0.514),satisfaction with the self-paid premium(OR=0.608),and allocation of medical facilities of the NRCMS(OR=0.549).Conclusion The rate of participation in the NRCMS is lower than that expected by the provincial government and is influenced by educational level,medical care cost during the previous one year,and knowledge about and satisfaction with the system among the rural residents in Heilongjiang province.