Aims and objectives. To explore the impact of delivery mode on womens postpartum quality of life in rural China and probe factors influencing postnatal quality of life. Background. Childbirth significantly affects puerperas physical, psychological and social domains of quality of life. Under the circumstance of increasing high caesarean section rate in rural China, the impact of delivery mode on postnatal quality of life remains unclear. Design. Cross-sectional study design. Methods. Women residing in rural areas and in their 012 months after childbirth from 30 rural townships participated in a household survey. A structured questionnaire was used to evaluate womens socio-demographic characteristics, previous pregnant experiences, foetal characteristics and use of maternal health services. The scale for rural postnatal quality of life was adopted to assess postnatal quality of life from six dimensions: physical complaints and pain, sleep and energy, sex satisfaction, interpersonal communication, self-evaluated living stress and perceived life satisfaction. Results. The overall caeserean section rate was 70.0% (962/1375), and most of them (59.7%) were selected by maternal request. None of six dimensions and total score of quality of life displayed significant difference between women with normal delivery and cesaerean section. It was found that postnatal home visit related to good postnatal quality of life and lower husband education level, male gender of infant were associated with poor quality of life. Conclusions. Delivery mode did not affect postpartum quality of life in rural China. Socio-cultural determinants may contribute more in influencing postnatal quality of life. Relevance to clinical practice. Null findings in impact of delivery mode on postpartum quality of life may cause more difficulties in maternal decision-making for vaginal delivery in rural China. The importance of postnatal home visit could justify available and quality postnatal care in improving postpartum quality of life. Further research needs to explore the effective prevention programmes, especially attention for parenting boys.