Objective To assess the prevalence of cataract,the cataract surgical coverage rate,and the cataract-blindness social burden rate among older adults aged 50 years or above in rural populations in Shandong Province,China,in 2008.Design Population-based,cross-sectional study.Participants 17 816 individuals aged 50 years or above in three counties and one suburbs representative of the different levels of socioeconomic development.Methods Visual acuity (VA),lens and cataract operation status of all the individuals were evaluated.Main Outcome Measures The prevalence of cataract,the rate of intraocular lens implantation,the cataract surgical coverage rate,and the cataract-blindness social burden rate.Results In 17 816 individuals,4938 cases were suffered from cataract; the prevalence of cataract was 27.72%.The prevalence of cataract was higher in older people,female,and illiterate persons (P<0.01).In 310 eyes with cataract surgery,62.58% and 10.32% of eyes were performed by the modern extra-capsular surgery and phocoemusification respectively.The rate of intraocular lens implantation was 77.10%.The cataract surgical coverage rate was 36.77%,and the cataract-blindness social burden rate was 2.12%.The cataract-blindness social burden rate was higher in the aged persons and illiterate persons (P<0.01).Conclusion The cataract surgical coverage rate is still lower in older adults aged 50 years or above in rural populations in Shandong Province.Surgery for cataract blindness is still the first important task in prevention of blindness in Shandong Province.