BackgroundThe urbanization process may affect the lifestyle of rural residents in China. Limited information exists on the extent of sedentarism and physical activity (PA) level of rural residents in middle-income countries. This is the first survey on sedentary time (ST) and PA among rural residents in eastern China.MethodsThis cross-sectional observational study randomly samples rural adults from Zhejiang Province in eastern China (n = 1,320). Participants' ST and PA levels were determined from the International Physical Activity Questionnaire Short Form through face-to-face interviews, and the influencing factors of PA levels were assessed through multi-class logistic regression analysis.ResultsThe findings showed that the daily ST of the participants ranged from 30 to 660 min, with a median of 240 min (P25, P75:120, 240 min), and 54.6% of participants were sedentary for 240 min or above. The daily ST in men, people aged 18 to 44 years, people with bachelors' degree and above, people working for government agencies or institutions, people with unmarried status, and people with an average income of < 2,000 Yuan was longer than that of other respective groups (p < 0.01). In contrast, the daily ST of people with hypertension or with patients with osteoporosis or osteopenia was less than that of normal people (p < 0.01). Additionally, 69.4% of participants generally had a low level of PA (LPA). Compared with those living in northern Zhejiang, people living in southern Zhejiang who were aged 18–44 years, had bachelor's degree or above, were farmers, and had household incomes below 10,000 Yuan per month were more likely to engage in LPA compared to people > 60 years, with high school or technical education levels or with junior college degrees, working in government agencies and institutions, and with household income above 10,000 Yuan per month (p < 0.05). Furthermore, there was no correlation between ST and PA levels.ConclusionMost rural residents in the Zhejiang Province of eastern China had longer daily ST and a LPA. This was predominant in men, young people, highly educated people, unmarried people, and middle to high-income people. Health education programs should be targeted toward specific population groups to decrease the ST and increase PA.