Abstract: Objective To analyse the association of serum adiponectin and hypersensitive C-reactive protein(hs-CRP) with pre-hypertension of rural residents in Ningxia, and to explore the effect of serum adiponectin and hs-CRP on pre-hypertensive. Methods On the basis of a cross-sectional study which was conducted in Ningxia during 2008-2012, subjects were classed by diagnostic criteria into three groups. Anthpometric data and blood samples were collected. Serum adiponectin and hs-CRP were measured with enzyme-linked immunosorbent assay. Results Serum adiponectin levels decreased with elevated blood pressure (Z=41.798,P<0.001), whereas an opposite pattern of differences was observed for serum hs-CRP (Z=31.213,P<0.001). After adjustment for confounders, serum adiponectin was inversely associated with body mass index(BMI),waist circumference(WC), waist-hip ratio(WHR), fasting blood glucose(FBG), HOMA-insulin resistance(HOMA-IR), diabolic blood pressure(DBP), total cholesterol(TC) and triglycerides(TG), and positively correlated with high density lipoprotein-cholesterol(HDL-C) (all P<0.05). A significant positive association also existed between serum hs-CRP and BMI, WC, WHR, FBG, systolic blood pressure(SBP) and TG (all P<0.05). Logistic regression analysis indicated serum adiponectin was independently associated with pre-hypertension(OR=0.462, 95% CI:0.263-0.811,P=0.007), hs-CRP may not be an independent risk factor of pre-hypertension in the rural residents in Ningxia(all P>0.05). Conclusions Serum adiponectin and serum hs-CRP levels were changed in pre-hypertensive, and related multiple cardiovascular risk factors in pre-hypertensive population. Serum adipomecin is the protective factor of pre-hypertensive.