Objective We aimed to examine the current developments and challenges confronted by old age security in rural China.

Datasources This study is based on the data from PubMed, Elsevier, Wiley, EBSCO, EMBASE, SCI Expanded, ProQuest, Google, and CNKI which is the most informative database in Chinese.

Studyselection Articles were selected with the search terms “rural”, “China”, “old”, “older”, or “elder”, “elderly”, or “aged”, “aging”, “security”, “culture”, “value”, “medical insurance” or “community based medical insurance” or “cooperative medical scheme”. Related websites and yearbooks were searched as well.

Results The socio-economic development has made the burden of traditional care for the rural elderly heavier than ever, and new challenges are emerging in rural communities, such as poor economic, deteriorating natural environment and health crisis.

Conclusions The governments should improve the scale and caliber of rural old age security and strengthen regulations with great efforts in developing the rural economy and protecting the natural environment of rural communities.