A randomized cluster trial was conducted to assess the impact of individualized health intervention guided by the transtheoretical model (TTM) theory on behavior change and quality of life (QoL) among the older rural population of China. A total of 2441 persons aged 60 years and over participated in the study. After a nine-month intervention, brined vegetable intake, salt intake, and smoking decreased (p less than 0.001) while fresh vegetable and fresh fruit intake increased within the intervention group (p less than 0.01) after adjusting for sociodemographic characteristics. The intervention group improved significantly in role-physical, role-emotional, mental health, and mental component summary scale scores (p less than 0.05) after adjusting for sociodemographic characteristics, health behavior, and chronic disease status. The study shows that individualized health interventions are a feasible method of changing the health behaviors and improving the QoL in the older rural population of China. (Contains 6 tables and 1 figure.)