Objective: To investigate the loneliness and psychological resilience with the perceived social support of the left-behind elderly in rural areas and explore the moderating effect of psychological resilience on the understanding of social support and loneliness of the left-behind elderly in rural areas.Methods: A cross-sectional study was conducted; 272 left-behind elderly people in 6 rural villages in the Sichuan Province were investigated by using the General Situation Questionnaire, Perceived Social Support Scale (PSSS), Connor-Davidson Resilience Scale (CD-RISC), and the University of California at Los Angeles Loneliness Scale (UCLA) with a stratified random cluster sampling method.Results: The loneliness score of the left-behind elderly in rural areas was 52.54 ± 7.25, the psychological resilience score was 78 (68.87), and the perceived social support score was 57 (51.62). The perceived social support and psychological resilience were negatively correlated with loneliness, while the perceived social support was positively correlated with psychological resilience. The moderating effect of psychological resilience on the perceived social support and loneliness of the left-behind elderly in rural areas was ?0.102 (P < 0.001).Conclusions: Higher level resilience is of positive significance to alleviate the negative effect of social support on loneliness. Improving the resilience of the left-behind elderly in rural areas is a beneficial exploration to promote their mental health.