Abstract: Objective To study current status and related factors of catastrophic health expenditure(CHE) among rural inhabitants and to estimate the effect of catastrophic medical insurance of New Rural Cooperative Medical System(NRCMS) in Shenyang municipality, Liaoning province.Methods We used stratified random sampling method to select 3012 inhabitants from 912 families in rural areas of Shenyang municipality for a household questionnaire survey from May to December 2014.Related factors of household CHE were analyzed with dichotomies classification logistic regression.Results The incidence of CHE was 8.64% for the families with the annual per capita income of more than 20000 RMB yuan, with an average disparity of 2.33%, a relative disparity of 13.16%, and a concentration index of 0.33; while, for the families with the annual per capita income of less than 10000 RMB yuan, the CHE incidence was 51.38%, the average and relative disparity were 9.01% and 16.45%, and the concentration index was -0.31, respectively.The main influencing factors of CHE included familial annual income per capita, educational levels of family members, and whether having elder member of ≥65 years or with chronic disease patient in the family.Conclusion The results indicate that the CHE incidence is high among rural families with lower annual income and the government should improve the NRCMS and enhance the support to the poor population.