Objective To provide baseline data and decision-making basis for improving the health literacy level a-mong urban and rural residents in Dongyang city,Zhejiang province.Methods In September of 2023,a total of 800 resi-dents aged 18-59 were randomly selected from Baiyun Street and Huxi Township in Dongyang City of Zhejiang Province.The basic information of population sociology,the level of health literacy and the ways of obtaining were collected.Descriptive sta-tistics method were used to compare the awareness rate,total awareness and knowledge sources of health literacy between urban and rural residents.Results A total of 791 valid questionnaires were received from urban residents and 783 from rural resi-dents.There was a significant difference between urban and rural residents in educational level(x2=62.553,P<0.001).The awareness rate of health knowledge was 78.18%,in which the awareness rate of urban residents was 80.94%,and that of rural residents was 73.89%.Urban residents and rural residents had a good grasp of health literacy such as"Emergency knowledge","Healthy lifestyle"and"Basic knowledge of diseases",the awareness rates of urban residents were 94.15%,85.28%and 80.69%,while those of rural residents were 89.02%,76.68%and 74.07%,respectively.Totally,641(81.04%)urban residents and 579(73.94%)rural residents were aware of the knowledge of health literacy.The difference was statistically significant(x2=11.348,P<0.001).There were significant differences in the awareness rates of urban and rural residents at different ages and educational levels(x2=14.018,x2=7.759,all P<0.05).The number of urban resi-dents acquiring health literacy knowledge through TV(29.77%)and mobile phone(8.38%)was lower than that of rural residents(61.85%,53.41%).Urban residents obtained more knowledge from community propaganda(41.04%),public health lectures(51.23%),newspapers(53.76%)and posters(59.97%)than rural residents(30.19%,34.69%,34.54%,22.06%),the difference was significant(all P<0.05).Conclusion Influenced by age and education,the awareness rate of health literacy related knowledge between urban and rural residents was higher than that of rural residents.TV and mobile phone are the main sources of health literacy knowledge of rural residents.