Abstract: Objective To examine the status of out-patient clinic service utilization and to analyze its factors among rural left-behind old people in Miao minority villages.Methods A cross-sectional survey on out-patient clinic service utilization was conducted with a structured questionnaire among 112 old people at the age of 60 years or older in July 2011 in three Miao minority villages in Shibing county,Qiandongnan Autonomous Prefecture of Miao and Dong minorities,Guizhou province.Multivariate stepw ise logistic regressions were performed.Results The rate of visiting a doctor in the last two weeks was 47.3% (53/112) in the left-behind old people with illness and the rate of not visiting a doctor in the last two weeks was 52.7% (59/112).Among the 53 outpatients,66.0% (35/53) visited a doctor in a village clinic and 34.0% (18/53) visited a doctor in a tow nship health center level or above; 73.6% (39/53) of the outpatients waited for one hour or longer to see a doctor and 26.4% (14/53) waited for shorter than one hour; 79.2% (42/53) of the outpatients did not report the doctor mentioning about health care know ledge; 64.2% (34/53) did not report the doctors informing their states of the illness clearly; 52.8% (28/53) did not report the doctors explaining their prescription well.Totally 52.8% (28/53) of the outpatients were satisfied with the out-patient clinic service.The χ² value for the ability of speaking Han language,medical facility distance,health care know ledge,and severity of illness was 6.02,5.11,8.21,and 7.08,respectively.There was a significant difference in probability for visiting a doctor in last tw o weeks among the old people with different characteristics(P< 0.05 or P< 0.01).Health care know ledge and severity of illness played a positive role and the distance to the medical facility from the residentce played a negative role in the out-patient clinic service uses,with the odds ratios of 4.13,2.27,and 0.43,respectively.Conclusion The level of out-patient clinic service utilization was low among the left-behind old people.The utilization was influenced by health care know ledge,severity of illness,and the distance from the residence to the medical facility.