To estimate the prevalence of sexually transmitted infections (STI) and lower reproductive tract infections (RTI) and determine risk factors for STI among rural women in Sichuan Province, China, a cross-sectional, community-based cluster sample of 2,000 rural, married women were interviewed, examined and clinical specimens collected to assess for six STI and two non-sexually transmitted RTI. The overall prevalence of any STI was 10.9% (95% CI 9.5-12.3); of any STI or RTI was 30.8% (95% CI 28.7-32.8). Chlamydia trachomatis was detected in 6.4% of women, Neisseria gonorrhoeae in 1.7%, Treponema pallidum in 0.5%, human papilloma virus in 0.6%, herpes simplex virus type-2 in 2.0%, Candida albicans in 8.8%, Trichomonas vaginalis in 0.7% and bacterial vaginosis in 15.4%. The reported low risk sexual behavior was corroborated by the prevalence of STIbased on laboratory findings. The prevalence of Chlamydia trachomatis alone and the combined prevalence rates of Neisseria gonorrhoeae and Chlamydia trachomatis were high enough (7.9%) to consider interventions for the control of cervical infections. Health promotion messages regarding safe sexual and health care seeking behavior is important. Routine STI surveillance, including prevalence studies, which provide accurate information for decision-making should be continued as an essential component of good STI control.