Objective: To investigate the willingness-to-pay for painless endoscopic screening among rural residents, to provide references for improving the screening strategy of upper gastrointestinal cancer and promoting screening sustainable development. Methods: Stratified cluster random sampling was used to select rural residents aged 40 ∼69 who had never been diagnosed with cancer in Shandong Province. Based on Contingent Valuation Method, a combination of double-bounded dichotomous choices and open-ended questions was used to investigate respondents' willingness-to-pay for painless endoscopic screening. The Chi-square test and Tobit regression for the influencing factors of respondents' willingness-to-pay were carried out with STATA 16.0 Software. Results: Of the 959 respondents, 86.97 %were willing to accept painless endoscopic screening, and 13.03 %stated unwillingness because they didn't attend clinics until symptom onset. 64.39 %of the residents were willing to pay part of the screening cost among those willing to accept screening. Assuming that the total screening cost was 1000 yuan, 30.70 %of the residents were willing to pay more than 500 yuan, 14.51 %were 700 yuan. The average willingness-to-pay was 310.70 yuan, accounting for 31.00 %of the total cost. Region, gender and income were the significant influencing factors of residents' willingness-to-pay. Residents in Feicheng were more willing to pay 118.85 yuan/person than residents in Linqu County, and male were more willing to pay 63.09 yuan/person than female. For every 10000 yuan increased in annual income, residents' willingness-to-pay would increase by 16.40 yuan/person. Conclusion: The acceptance for painless endoscopic screening among rural residents was considerable. The willingness-to-pay and payment amount were relatively low, indicating the necessity of improving residents' awareness on painless endoscopic screening and self-health responsibility, establishing screening co-payment mechanism, and controlling individuals' out-of-pocket at about 30.00 %.