Abstract: Objective To explore the relationship among mental health,resilience and self-esteem of rural middle school students in Sichuan province and to explore the difference of the three relationships between boys and girls,and to provide evidence for mental health intervention in the future.Methods Totally 262 students of grade 7 and grade 10 from 2 middle schools in the south rural area of Sichuan province were selected as research objects by cluster sampling method,and a cross-sectional survey was conducted by using mental health scale (MMHI-60),resilience scale(CD-DISC) and self-esteem scale(SES) as well as social demographic characteristics questionnaire.Structural equation model(SEM) was used for statistical analysis.Results The score of boys' mental health(2.08±0.68) was lower than that of girls(2.17±0.64) while both resilience and self-esteem of boys(56.65± 18.13,28.51±4.61) scored higher than girls' (51.73±17.13,27.87±4.46)(P<0.05).The results of SEM showed mental resilience and self-esteem directly affected mental health,and the effects were-0.094(95% CI =-0.147--0.017) and-0.360(95% CI =-0.405--0.309),respectively.The resilience was a mediator of the relationship between self-esteem and mental health and the mediatory effect was-0.052(95%CI=-0.084-0.016),accounting for 12.6% of the total effect.Multiple group analysis of SEM showed that the difference values of parameters for structural equation model of boys and girls were all less than 0.005.The absolute value of critical ratios for path coefficients were all less than 1.96.Conclusion Resilience and self-esteem are the direct protective factors of mental health among the middle school students in rural area of SichuanProvince,and self-esteem is an indirect factor of mental health.