Background: Previous studies have demonstrated that physical illness might be associated with suicide behaviour.However, characteristic differences are unclear between suicides with physical illnesses and those without in rural China.This study is aimed to find some characteristics of rural suicides with physical illnesses and those without in rural China, and in order to provide some special measures for preventing suicide.Methods: Psychological autopsy case-control study method was used.Two hundred suicides occurred between September 1st, 2008 and August 31st, 2009 was obtained from 25 townships of 3 counties which were selected randomly from diseases surveillance points of Shandong Province.One informant of suicide or paired control matched with the same age (±3 years), same gender and residence as the suicide was used to collect the data of suicides and controls.In addition to information about demographic characteristics of subjects, several psychological assessment scales were used as follows: Becks Suicide Intent Scale (SIS), Interview for Recent Life Events (IRLE), Social Support Rating Scale (SSRS), Beck Hopelessness Scale (BHS), Trait Anxiety Inventory (TAI), Barratt Impulsiveness Scale-11, and Simplified Coping Style Questionnaire (SCSQ).Results: There were 126 (63.0%) suicides with physical illnesses and 74 (37.0%) suicides without.The major physical illnesses among the 126 suicides with physical illnesses were stroke (18.3%), tumour (10.3%), heart diseases (7.9%), and hypertension (7.1%).The mean ages were (66.4, SD: 14.02) in suicide with physical illnesses and (50.74, SD: 19.66) in those without, respectively (t =-5.655, p < 0.001).There were no significant difference in the per cent of female between suicides with physical illness (41.3%) and those without (44.6%) (X2 =0.980, p =0.646).There was no significant difference in ingesting pesticide in two groups (63.5% vs.55.4%; X2 =0.946, p =0.331).Compared to the suicides without physical illnesses, suicides with physical illnesses were elder, lower education level (2.09 ± 2.99 vs.4.39 ± 3.76), fewer family members (2.46 ± 1.48 vs.2.99 ± 1.28), less working time (12.06 ± 19.85 vs.20.87 ± 23.76), less family income (5201.65 ± 7237.60 vs.9868.99 ± 10278.39), less per cent of mental illness (11.1% vs.33.8%), and high score of BHS (64.64 ± 16.36 vs.58.75 ± 17.18), all p<0.05.Multivariate logistic regression analysis indicated that there were interactions in suicide between physical illness and the elder age (OR =1.056, 95% Cl =1.033-1.079), high score of BHS (OR =1.034, 95% Cl =1.012-1.058) and lower family status (OR =24.055, 95% Cl =3.789-152.721).Conclusion: Some characteristics are significantly different between the suicides with physical illnesses and those without.There are interactions between physical illnesses and elder age, hopelessness, lower family status in the rural suicides.