Objective: To study the urban and rural difference impacts of aging on health care expenditure. Methods: Using 2002-2011 panel data of 31 provinces throughout the country to build fixed effect models for the urban and rural areas and make comparative analysis. Results: For urban and rural areas, there are significant differences in the impact of aging on health care expenditure, the estimated coefficients are 0.13 and 0.48 respectively. Conclusion:Under the background of the aging process, it needs to strengthen the construction of rural medical insurance system in China, increase financial support and rural health resource allocation.