Abstract: Objective To understand the prevalence of clonorchiasis sinensis and related factors among residents in western hilly area of Zhejiang province. Methods A total of 1530 residents in 20 townships selected by multi stage stratified cluster sampling received questionnaire survey, and blood samples were taken from 1505 of them to detect clonorchis sinensis antibody with ELISA. The infection of metacerearia of clonorchis sinensis in second intermediate hosts were detected too. Results The overall antibody positive rate was 0.67% in human. Up to 87.0% of people surveyed did not know that the disease can be acquired through eating raw fish and 14.10% of them had history of eating raw fish. A total of 20 kinds of fish/shrimp were detected, and the infection rate in these second intermediate hosts was 6.7%. Conclusion The prevalence of clonorchiasis sinensis was low in human in western Zhejiang, but the risk of infection still exists. The health education needs to be further strengthened.