Objective To investigate the awareness and possible influencing factors of clonorchiasis among residents at different economic levels in Hunan province. Methods Multi-stage cluster sampling were used to extract 1 490 effective subjects, SPSS 16.0 and MLwiN 2.02 softwares were used to analyze the data, and the influencing factors of the awareness were analyzed by multi-level Logistic regression. Results The awareness were different among different economic level regions(according to the order of developed areas/more developed areas/less developed areas, the superior proportion were 10.71%, 7.24%, 7.17%, the poor proportion were 22.03%, 24.79%, 12.95%)(χ²=33.964, P < 0.001), the rate of awareness in economically developed areas and economically underdeveloped areas showed a trend of polarization. The awareness of different diseases was different(according to the order of pathogenic characteristics, clinical manifestations, epidemiological features, the order of personal precautions, the superior proportion were 5.32%, 11.27%, 16.35%, 4.14%, the poor proportion were 32.14%, 24.59%, 19.70%, 28.77%)(χ²=48.823, P < 0.001). The social factors that affect the rate of awareness were disease prevention information acquisition channels(95%CI:0.141-0.706) and ethnic groups (95%CI:2.418-7.222), the clinical factors affecting the awareness were frequency of diarrhea(95%CI:0.113-0.860), history of food poisoning(95%CI:0.121-0.687) and history of parasitic diseases(95%CI:0.134-0.849). Conclusion The key areas for health education of clonorchiasis in Hunan province should be the developed areas, the emphasis of health education are etiological knowledge and personal daily prevention knowledge. At the same time we can also combine the social and clinical factors to carry out the health education for the special population.