Abstract: Objective To investigate the adequate health literacy(AHL)status and to analyze its influencing factors in rural occupational populations in China,and to provide scientific evidence for developing intervention strategies of health literacy. Methods The investigation covered 32 987 workers in rural areas aged 15-69 years selected from all provinces,autonomous regions,and municipalities of mainland China with multistage stratified random sampling method. A face-to-face questionnaire survey was conducted among the workers. Results The proportion of adequate health literacy (PAHL)among the rural workers was 3.98%.The proportion of the workers with AHL in mental,light physical labor, agriculture workers,and farmers was 16.90%,16.20%,2.14%,and 4.50% respectively.The proportion of AHL for health concept and know ledge,lifestyle and behavior,and related skills among the workers was 10.14%,4.09%,and 13.05%,respectively.In addition,the proportion of AHL was 23.35%,11.35%,2.77%,12.33%,and 4.76%,respectively,for the follow ing health issues:attitude tow ards health,safety and first aid,infectious diseases prevention,basic medical care,and chronic non-communicable diseases prevention.logistic regression analysis results indicated that education(odds ratioOR=0.497),occupation(OR=-0.222),nationality(OR=-0.175),region(OR=-0.1670.071),age(OR=-0.094),and marriage(OR=0.049)were important influencing factors of AHL level in rural occupational populations.The educational level was positively correlated with the proportion of PAHL.PAHL was lower among elder people and the minority.The PAHL in the workers in central China was higher than that in the eastern China and PAHL was lowest in the workers of the Western. Conclusion Education,occupation,nationality,region,age,and marriage are important influence factors of health literacy and special intervention measures should be focused on these factors to improve health literacy among the rural occupational populations.