Objective: To understand parent child communication about sex related topics in rural areas of Sichuan Province, and to provide the basis for family sex education. Methods: A multi stage stratified cluster sampling was adopted to select 2 801 parents of children from 53 township kindergartens in Sichuan Province. Questionnaires were conducted to parents about sex education in family by face to face interview or self filling. Results: About 41.63% of parents reported that children had questions about sex, and the rate of proper parent child communication was 57.46%. The results of binary unconditional Logistic regression analysis showed that township residence( OR=1.46, 95%CI =1.12-1.90), high school or higher educational background of mothers( OR= 1.77 , 95%CI =1.38-2.28), non-left-behind children( OR=1.32, 95%CI =1.03-1.69), supportive for parent child communication about sex related topics( OR=1.66, 95%CI =1.05-2.63), sex education at home( OR=1.60, 95%CI =1.25-2.05) were associated with a higher rate of proper parent child communication on sex( P <0.05). Conclusion In rural areas of Sichuan, proper parent child communication about sex related topics was not common. It is suggested that in rural areas, parents should enhance their awareness of the knowledge and importance of children s sex education, and improve the coping methods of children s sex-related problems so as to promote the healthy growth of children s body and mind.