Abstract: Objective To analyze self-rated health and its influencing factors among rural residents in China and to provide a scientific basis for improving health status of Chinese rural population.Methods A household questionnaire interview was conducted among 10161 rural residents aged 18 years and above selected with multistage random sampling and probability proportional to size sampling from 48 villages of 15 counties in 6 provinces, one autonomous region and one municipality from January 2011 through April 2012.Kruskal-Wallis rank test, Spearman rank correlation and ordered logistic multivariate regression were used to analyze the data collected on self-rated health and its related factors.Results Of the residents surveyed, 4116(40.51%) were male and 6045(59.49%) were female, with an average age of 47.08 years; 4654(45.81%), 4249(41.82%), and 1258(12.37%) had the education of primary school or below, middle school, and high school or above;7594(74.74%) were engaged in agriculture work and 2567(25.26%) in other occupations.Among the residents, 71.47%(7262) reported very good/good health status, while 28.53%(2899) considered their health status being not good enough.The results of ordered logistic multivariate regression demonstrated that self-rated health level declined with the increment of age and familial medical expenditure(both P<0.01), but increased with education level and self-reported familial economic condition(both P<0.01);the residents with stable employment reported a significantly higher health status than the residents being farmer, temporary worker, and individual industrialist or businessman(P<0.05);the residents in Henan province reported a higher health status than those in Hebei province, Hainan province, Ningxia Hui Autonomous Region, and Beijing municipality but a lower health status than those in Shandong, Heilongjiang, and Jiangsu province (P<0.05 for all);compared to those with chronic diseases and low familial economic condition, the residents with medical security and general familial economic condition had a better self-rated health(both P<0.01);the residents with the perspective of being easy to borrow 5000 yuan RMB from their neighbors reported a better health than those without the perspective(P<0.01).Conclusion Self-rated health is negatively related to age and familial medical expenditure and positively to education, social economic condition, and the easiness to borrow 5000 yuan RMB from neighbors, and there is a regional difference in self-rated health among rural adult residents in China;the residents with chronic diseases, poor familial economic condition, medical insurance and being a farmer, temporary worker or individual industrialist or businessman have a lower self-rated health.