Background:　Physical　illness　is　a　strong　correlate　of　suicidal　behavior.　However,　its　impact　on　attempted　suicide　in　rural　China　is　under-studied.　Aims:　This　study　was　designed　to　assess　the　influence　of　physical　illness　on　risk　of　suicide　attempts　and　to　identify　distinguishing　characteristics　among　medically　serious　suicide　attempters　with　physical　illnesses　from　those　without.　Method:　Participants　were　medically　serious　suicide　attempters　identified　through　hospital　emergency　rooms　(n　=　659)　as　well　as　age-　and　gender-matched　community　controls　(n　=　659)　from　Shandong　Province,　China.　Face-to-face　interviews　with　the　respondents　were　conducted　with　a　semistructured　protocol　that　included　sociodemographic　and　psychological　measures.　Results:　Physical　illness　was　a　significant　risk　factor　for　medically　serious　suicide　attempts　(OR　=　1.739,　95%　CI　=　1.182-2.560).　Older　age　was　a　significant　risk　factor,　while　female　gender,　no　religion,　and　non-peasant　occupations　were　significant　protective　factors　for　suicide　attempts　with　physical　illness.　Limitations:　Samples　from　only　one　province　may　not　completely　represent　all　serious　suicide　attempters　in　China.　Furthermore,　we　did　not　assess　the　severity　and　the　degree　to　which　their　physical　illness　limited　the　functioning　of　the　individual.　Conclusion:　Physical　illness　is　an　important　risk　factor　for　suicide　attempts　in　rural　China.　More　efforts　are　needed　to　specifically　target　older　people,　males,　those　with　religious　beliefs,　and　peasant　workers　with　physical　illness.　©　2019　Hogrefe　Publishing.