Conclusion:This study investigated poverty and impoverishment by medical expenses in China and identified the determinants from the aspect of demographic and health service needs and utilization factors. Te results highlighted the joint roles of economic development, health service utilization, and welfare policies. Poverty and health service utilization are indicative of households with high incidence of medical impoverishment. Chronic diseases lead to medical impoverishment. Te inequity existing in different medical insurance schemes leads to different degrees of IME risk. A combined strategy to precisely target multiple vulnerabilities of poor population should be more effective.