ObjectivesTo reveal the prevalence and associated influencing factors of hepatitis B among a rural residential population in Zhejiang, China, in order to help develop specific control strategies.MethodsWe conducted a cross-sectional study among a rural residential population in Zhejiang, China. Stratified multistage cluster sampling was utilised in five districts; a structured questionnaire was used to collect the information such as age, gender, education, occupation, living status, and other health related information of the participants by trained local staff; and the hepatitis B virus (HBV) infection status of the participants was determined by the chemiluminescence immunoassay test. Univariate and multivariate analyses were applied to evaluate the influencing factors of HBV infection. The odds ratio of each related factor was assessed with or without adjustment separately.ResultsThe mean age of the 16 601 participants (7881 males and 8720 females) who completed the survey was 40.28±19.47 years. The positive rate of hepatitis B surface antigen (HBsAg) was 4.04% (95% CI 3.74% to 4.35%), and 3.85% when standardised by age and gender. Univariate analysis showed that age, educational level, occupation, living status, history of hepatitis B examinations, history of blood transfusion, vaccination, family history, coastal living, and district were the potential influencing factors. Multivariate logistic regression indicated that occupation, living status, history of hepatitis B examinations, vaccination and district were the influencing factors. Undertaking a service-based tertiary industry job (ORa 1.19, 95% CI 0.94 to 1.51) and non-single living (ORa 2.84, 95% CI 2.17 to 3.70) might be risk factors, while vaccination (ORa 0.43, 95% CI 0.34 to 0.53) and history of hepatitis B examinations (ORa 0.71, 95% CI 0.48 to 1.03) were potential protective factors.ConclusionsThe prevalence of hepatitis B is at an intermediate epidemic level in a rural residential population in Zhejiang, China. Raising vaccination coverage, especially in adults, is a suitable strategy for the prevention and control of hepatitis B.