Abstract: Objective To examine the expenditure on health care and treatment among families of children with autism spectrum disorder (ASD) in Heilongjiang Province.Methods The self-designed questionnaire "Status of Autistic Children Rehabilitation and Health Service Utilization" was used to investigate the financial cost in families of ASD children.Caregivers of 314 ASD children were recruited from twelve rehabilitation institutions from five cities in Heilongjiang Province.Results The total cost of rehabilitation for children with ASD in Heilongjiang province was 64.4 thousand Yuan per year,accounting for 193.7% of the total household income and 68.6% of the total household expenditure.Regardless of urban and rural areas,rehabilitation and transportation accounted for the largest share of both income and expenditure,followed by housing rental,consulting and medical treatment.In the survey,118(37.6%) ASD children benefited from the government financial assistance.A total of 81.5% of families considered the total cost of rehabilitation treatment being a major determinant to the family economic hardship.Conclusion The cost of rehabilitation of ASD children has caused a serious financial burden on their families.It is necessary to expand the coverage of benefiting ASD further to minimize the disease burden and mental stress on their families.