Abstract: Few studies were conducted on risk factor in medication nonadherence in developing rural area in China. The goal of this study was to perform a survey to address the prevalence of medication nonadherence and the reasons for nonadherence. Outpatients with chronic diseases (chronic obstructive pulmonary disease, diabetes, hyperlipidemia, hypertension, etc) in a rural hospital far away from Shanghai downtown, from Jan 1 to June 30, 2014 were invited to participate in this survey. Patients were answered a combination questionnaire including self-reported medication adherence and depression/anxiety symptoms. A total of 325 patients with chronic diseases were treated with regular medication without any anti-anxiety drugs or antidepressants. The 255 (78.5%) patients were regarded as medication nonadherence. Age, gender, educational level, brand preference and health literacy were not associated with medication adherence, while the number of chronic diseases, anxiety and depression were negatively impact medication adherence. Depression and anxiety symptoms are possible risk factors causing the nonadherence.