Abstract: Objective To analyze the status and inequality of preventive healthcare service utilization among rural residents and to explore the source of the inequality.Methods With stratified random sampling,6 525 residents were selected from 3 counties in Ji'nan municipality for a household questionnaire survey in August 2012.Concentration index(CI)and decomposition of CI were used to analyze the status and inequality of preventive healthcare services utilization among the participants.Results Of the participants,6.39% reported utilization of preventive healthcare service during four weeks before the survey,with a CI of 0.062.The main services utilized by the participants were general health examination (46.34%),hypertension screening (23.50%),routine blood test (12.64%),and gynecologic examination(9.98%).Gender,age,occupation,whether with chronic disease,and income were significant influence factors for the utilization of preventive healthcare services (all P<0.05).Main contributors to the inequality of preventive healthcare service utilization were income,age,self-assessed health status,and with chronic disease,with the contribution rates of 158%,-73%,-9%,and -7%,respectively.Conclusion Inequality exists for the utilization of preventive healthcare service and income is a major positive contributor but age and health status are negative contributors to the inequality among the rural residents.