Abstract: Objective To study essential drug use behavior and its impact factors in rural residents and to provide suggestions for intervention on rational drug use in the residens.Methods Using multi-stage stratified random sampling,2 867 rural residents aged ≥15 years in 1 518 households were selected from five cities of Shandong province and investigated with a questionnaire survey.The data collected were analyzed statistically based on core framework of the theory of planned behavior(TPB).Results The most of the residents(95.9%) were satisfied to the essential drug policy,but there were parts of the residents reporting unsatisfied expectation to the quality(58.9%),price(58.8%),convenience of purchasement(48.4%),curative effect(46.8%),and types(15.4%) of the essential drugs.The proportion of the residents accepting essential drugs recommended by the doctors was 84.8% and that of taking the essential drugs exactly as the doctors' prescriptions was 92.3%.But most of the residents(94.3%) were lack of knowledge about medication and some of the residents reported the preference for new drug(12.4%),expensive drug(15.0%),imported drugs(24.8%),multi-drug medication(37.7%),and intravenous infusion(10.9%).Among the residents,46.3% took antibiotics when having a common cold and 39.3% kept antibiotics at home for self-medication.Conclusion The key factors affecting rural resident's rational use of essential drugs include perceived benefit of essential drugs policy,prescription behavior of the doctors,and medication knowledge and habit of the residents.