Objective: This study explored the relationship between childhood maltreatment and adolescent suicide provides a scientific basis for suicide prevention strategies. Methods: A total of 16 271 middle and high school students from rural areas in Anhui, Guangdong, Yunnan, Heilongjiang and Hubei provinces were enrolled through multi stage stratified cluster random sampling. Structured questionnaires were used to collect information on participants general information, childhood neglect, abuse, suicide ideation, suicide plans and suicide attempts in the 12 months prior to the survey. Multivariate Logistic regression models were used to analyze the associations of childhood neglect and childhood maltreatment with suicide ideation, suicide plans and suicide attempts. Results: The number of suicide ideations, suicide plans and suicide attempts among rural adolescents were 2 453( 15.1 %), 1 164(7.2%) and 572(3.5%), respectively. The number of cases of childhood neglect, moderate physical abuse and severe physical abuse were 10 756(66.1%), 4 311(26.5%) and 703(4.3%), respectively. Univariate analysis showed that childhood neglect and abuse were significantly associated with suicide ideation, suicide plans and suicide attempts( P <0.05). After controlling for age, gender, only children, parental education level, income, emotional management and social support, childhood neglect and abuse remained significantly correlated with suicide ideation, suicide plans and suicide attempts( OR =1.62-5.14, P <0.05); the OR(OR 95%CI) for severe physical abuse were 3.00(2.49-3.62), 3.52(2.81-4.40),5.14(3.87-6.83) respectively. Conclusion Childhood neglect and abuse may increase the risk of suicide among adolescents in rural China, and effective measures should be taken to reduce childhood neglect and abuse and prevent suicide.