This study aimed to assess the structure and capacity of Chinese infectious disease surveillance system, and to provide baseline information for developing syndromic surveillance system in rural China. Findings showed the current case report system has established a solid basis for developing syndromic surveillance system. However, the lack of computerized patient registration in village and township health care facilities, incomplete internet coverage in rural area and relatively low quality of human resource in village level post challenges for the establishment of syndromic surveillance system in rural China.