Objective: To understand the status and related factors of quality of life (QOL) among children aged 4-5 years old in rural areas of Anhui Province, and to provide a reference for improving the quality of life among children in rural areas. Methods: A total of 4 457 preschool children aged 4-5 years old were selected from rural areas in five counties of Anhui Province by cluster sampling method. Parents of children were surveyed using the Pediatric Quality of Life Inventory Measurement Models 4.0. Results: The total QOL score of children aged 4-5 years old in rural areas of Anhui Province was (79.44±12.51). The scores of emotional function, school performance and psychosocial summary were higher in left-behind children than that in non-left-behind children(t=2.99, 3.51, 3.22, P<0.05). Multivariate Logistic regression analysis showed that the older children (OR=0.82, 95%CI=0.71-0.95) and the bigger size of households (OR=0.85, 95%CI=0.73-0.98) were positively associated with quality of life of children, while the higher father’s educational level(OR=1.40, 95%CI=1.21-1.62), the lower father’s income, mothers doing housework or unemployment and children suffering from illness in the past two weeks (OR=1.76, 95%CI=1.50-2.06) were negatively associated with quality of life of children(P<0.05). Conclusion The quality of life of children aged 4-5 year old in rural areas of Anhui Province is relatively low. The children’s age, the father’s education level, the father’s annual income, the mother’s occupation, the size of households, and children suffering from illness in the past two weeks were the related factors that affectchildren’s quality of life.