poor sleep quality is associated with negative health outcomes and high treatment burden. this study investigated the prevalence of poor sleep quality and its socio-demographic correlates among older adults in Hebei province, which is a predominantly agricultural region of china. A large-scale cross-sectional epidemiological survey was conducted from April to August 2016. The study used a multistage, stratified, cluster random sampling method. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). A total of 3,911 participants were included. The prevalence of poor sleep quality (defined as PSQI > 7) was 21.0% (95% CI 19.7-22.2%), with 22.3% (95% CI 20.9-23.8%) in rural areas and 15.9% (95% CI 13.4-18.4%) in urban areas. Multivariable logistic regression analyses found that female gender (P < 0.001, OR 2.4, 95% CI 2.00-2.82), rural areas (P = 0.002, OR 1.5, 95% CI 1.14-1.86), presence of major medical conditions (P < 0.001, OR 2.4, 95% CI 2.02-2.96) and family history of psychiatric disorders (P < 0.001, OR 2.7, 95% CI 1.60-4.39) were independently associated with higher risk of poor sleep quality. poor sleep quality was common among older adults in Hebei province of china. Regular assessment of sleep quality and accessible sleep treatments for older population should be provided in agricultural areas of china. Older adults are more likely to suffer from poor sleep quality compared to younger adults due to more frequent physical and mental disorders 1. More than half of older adults complain about poor sleep quality 2,3 , including increased awakenings, low sleep efficiency, poor subjective sleep quality and decreased night sleep duration 1,4. Poor sleep quality is associated with negative health outcomes, such as fatigue, low quality of life, risk of medical and psychiatric comorbidities and even mortality 5-7. Sleep quality can be measured with both objective [e.g., polysomnography (PSG)], and subjective instruments [e.g., sleep diary and Pittsburgh Sleep Quality Index (PSQI)] 8. Of these, the PSQI is the most widely used measure of global sleep quality which covers subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, daytime dysfunction, and use of sleep medications. Determining the prevalence of poor sleep quality is important for health professionals and policymakers to understand its impact on population health and the need for appropriate preventive strategies and health resource allocations. In the past decade, epidemiological studies have examined the prevalence of poor sleep quality among older adults in various countries. For instance, the prevalence of poor sleep quality in older adults was 37.3% in Japan 9 , while the corresponding figure was 64.3% in Korea 10. Several studies explored sleep quality among older adults in low-and middle-income countries in Africa, Asia and North America, with the prevalence ranging from 7.7% to 40.0% 11-13. As the pattern of sleep problems including poor sleep quality is greatly influenced by