Abstract: Objective To survey the family medical expense of rural residents and health resoueces access, to explore the main factors raising the family medical expense. Methods Stratified cluster random sampling method was used to investigate 3 659 rural families with 15309 residents in Chuxiong prefecture. Results The median of family annual medical expense was RMB 1 987.5 yuan. 65.1% of households from the nearest hospital within 1 km, which was higher than the average level of FNHSS. 70.6% of households from the nearest hospital within 10 minutes, which was lower than the national average level. A Muitiple Linear Regression Analysis indicated that the time and distance from home to the nearest hospital, the persons with two week prevalence without consultation rate, the persons with two week consultation rate and the persons with annual hospitalization rate were positively associated with the high the family medical expense. Conclusions Rural health services can basically meet the people's needs. Although the difficulty in getting health services is being ameliorated, the medical charge is still the main restricting factor of utilization rate. It is suggested that the health education should be strengthened in rural areas, the accessibility of health services be improved, and the residents' health differences among regions should be reduced.