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Background: Burden of non-communicable diseases (NCDs) is increasing rapidly in most of the developing countries including China, even in rural areas. Dearth of representative data called for an investigation to estimate the burden and identify the correlates of NCDs in rural China. Methods: A cross-sectional study was conducted involving a representative sample of 6003 consenting randomly selected rural residents aged 15 years or more, from 36 villages of Shijiazhuang in Hebei province of China between July 2010 and June 2011. Information on demographics and behavior were collected, body mass index (BMI) and blood pressure were measured and blood samples were tested to diagnose diabetes and hyperlipidemia. Results: Majority participants were aged < 30 year, married and educated up to junior/senior high school level. Mean age for the 6003 participants was 37.4 ± 14.8. About 55.7 % had BMI of 18.6-24.9. In past 12 months: 19.8 % smoked daily, 41.6 % were exposed to passive smoking, 28.5 % drank alcohol, 10.4 % skipped breakfasts frequently, 82.8 % did never exercise and 25.3 % had psychological disturbances. 51.1 % were hypertensive, 6.7 % were diabetic and 9.2 % had hyperlipidemia. Based on self-reports, cardiovascular diseases (4.5 %), cerebrovascular diseases (2.3 %), cancers (0.2 %), chronic obstructive pulmonary diseases (2 %), orthopedic problems (12.1 %) and gastrointestinal NCDs (7.8 %) were identified among the participants, while proportion of subjects with one, two and three or more NCDs were 43 %, 14.4 % and 5.5 % respectively. Higher odds of having more NCDs were associated with higher BMI (Kg/M2), family history of NCDs, daily and past history of smoking and drinking, passive smoking, lack of exercise, skipping breakfast and psychological disturbances. Conclusion: Despite limitations associated with cross-sectional design and self-reporting, observation in this large sample of rural residents could develop important insights regarding high burden of NCDs in this population. Based on the identified correlates, targeted intervention strategies seem to be required urgently to control NCDs in rural China. [ABSTRACT FROM AUTHOR]