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To measure, describe and analyse regional differences in health-related quality of life measured by EQ-5D in China. Data were obtained via face-to-face interviews on a national representative sample (n=120,703, 15–103 years). The EQ-5D instrument was used to measure health status.Rural areas had worse health status than urban areas. Health status was worst in western areas and best in eastern areas, and such disparities were profounder in rural areas. In urban areas, health status was best in middle-sized cities. In rural areas, health status increased with the economic development level of a county.Our study enhances understanding of the urban–rural differences and east–middle–west differences in health and sheds light on inequalities in health status between different city categories in the urban areas and county categories in the rural areas.