Objective To know health service demand and utilization status of rural residents in Zhaotong,and find out relevant influencing factors so a to provide reference basis for formulating health policy. Methods Stratified random cluster sampling method was used to selected 10584 residents of total 3645 families in three counties(districts)in Zhaotong. Knew about health service demand and utilization status of rural residents through two-weeks outpatient rate,two-weeks outpatient times and two-weeks sicken,analyzed influence factors by dichotomy logistic regression and zero-inflated poisson model. Results Two-weeks outpatient rate was 4.7% in rural residents of Zhaotong city,two-weeks sicken rate was 73.49%. Health service demand was affected by age,sex,occupation,marital status and per capita income. And the influence factors of health services utilization were sex,occupation,education level and per capita income. Conclusions The level of health service demand and utilization of rural residents in Zhaotong city is lower than the national rural average level. The farmers have higher demand for health services,but the utilization of health service is inadequate. The possibility of treatment in low income group and male is low. The severity of illness is high when these people visit doctor. We should pay more attention to health service demand and utilization status of male,farmers and low income group.