Abstract: Objective: To explore the sleep quality and its influencing factors of rural left-behind elderly in Hunan province.Methods: To investigate the sleep quality and it's influencing factors of the 566 rural left-behind elderly with Pittsburgh Sleep Quality Index (PSQI) and demographics. Results: The average score of PSQI of the 566 rural left-behind elderly was 7.50±3.81,42.1% elderlys had bad sleep quality. Female, illness within two weeks, and poor ADL skills are the main risk factors,while strong social support and children return are the positive factors. Conclusion: The overall sleep quality of rural left-behind elderly is poor and can be affected by social-psychological and physical factors. Various means should be taken to improve the overall sleep quality among the elderly.