Till now, no evidence illustrates the prevalence and predictors of metabolically healthy obesity (MHO) in rural areas of China. The objective of this study was, firstly, to examine the prevalence of MHO in rural areas of China, and identify contributing determinants of MHO, Secondly, to comprehensively investigate to the different characteristics between MHO and metabolically unhealthy obesity (MUO). We conducted a population-based cross-sectional study of 2037 participants with obesity in rural Liaoning Province during 2012-2013. Obesity was defined as BMI28kg/m(2) and metabolically healthy was defined as not having the metabolic syndrome. The prevalence of MHO was 23.1%, and significantly decreased with advancing age in female group. However there was no significant tendency with advancing age in male group. Independent determinant factors for MHO were age<55years (odds ratio [OR] 1.659; p=.001), non-current smoking (OR 1.397; p=.038), pre-menopause (OR 1.648; p=.030) and non-hyperuricemia (OR 2.317; p<.001), whereas race, gender, diet score, current drinking, marriage, sleep duration, hyperhomocysteinemia, levels of physical activity, annual income and educational status were not significant contributors. In conclusion, we found that age<55years, non-current smoking, pre-menopause and non-hyperuricemia were identified as independent determinant factors for MHO in this population.