This study aims to investigate the developmental status of rural Chinese children, the extent of interactive parenting they receive, and the relation between the two. A sample of 448 six to eighteen-month-old children and their caregivers were randomly selected from two rural counties in Hebei and Yunnan provinces. According the third edition of the Bayley Scales of Infant and Toddler Development, 48.7% of sample children exhibited cognitive delays, 40.6% language delays, and 35% social-emotional delays. According to responses from caregivers, parenting in rural China is largely passive, lacking in interactive practices like storytelling, singing, and playing. Children-with-siblings, left-behind children, and children with less-educated mothers were even less likely to receive interactive practices. Children of caregivers who did engage in best parenting practices showed better cognitive, language, and social-emotional development; however, the public health system provides no platform for learning about optimal parenting.