Background: In China, rural female suicide rate is 30.5/100,000, ranking the highest among urban female, urban male and rural male.Suicide is the first leading cause of death for rural youth female.Rural female suicide is an important social and public issue.So we should pay more attention to Chinese rural female suicides.This study aims to explore the characteristics of suicidal behaviours and risk factors for rural female suicides and to provide scientific basis for effective intervening measures.Methods: This study was supported by the Postdoctoral Innovative Projects of Shandong Province.200 cases happened from September 1st, 2008 to August 31st, 2009 and their paired controls were successfully recruited from twenty-five towns of three counties randomly chosen from disease surveillance points of Shandong Province.Eventually, 85 rural female suicides and their paired controls were acquired as our targets.Case control psychological autopsy method was used to collect data by face to face interviews.Results: Rural female tended to commit suicide at their own houses by ingestion of poison and hanging, with low preparation and intent, mainly after family conflicts or acute stress.For rural female suicides, the mean age was 59.54 years, with poorer health status (X2=12.87, P=0.002) and they were more likely to be alone in marital status (X2=5.69, P=0.017) and believe in superstition (X2=11.05, P=0.001), with positive family suicide history (X2=11.05, P=0.001).By multivariate unconditional Logistic regression model, four factors were shown to be related with rural female suicides, which were superstition (OR=6.644, 95%Cl=1.002~44.075), family suicide history (OR=0.038, 95%Cl=0.005~0.325), hopelessness (OR=1.147, 95%Cl=1.097~1.200) and negative life events (OR=4.302, 95%Cl=.359~13.621).By analysis of interactions, there were positive interactions between every two factors among superstition, positive family suicide history, hopelessness and negative life events.Conclusions: Four risk factors were found to be related with rural female suicides by unconditional Logistic regression model, which were superstition, positive family suicide history, hopelessness and negative life events.The presence of any two factors will increase the risk of rural female suicide.Positive and effective control measures should be taken to reduce rural female suicide rate, such as controlling the feasibility of pesticides, improving the living standards of rural female and their educational level and enhancing primary care needs and social security system.