Based on the perspective of farmers’ participating in new rural cooperative medical care,this paper selects Z Village in Hubei province as a study case and uses social justice theory and empirical analysis to research farmers’ fairness perception and its functions on farmers’ satisfaction in the system operation.This paper also makes an objective evaluation on the operation effect of new rural cooperative medical care system.The result shows that in the operation of new rural cooperative medical care system,farmers’ fairness perception on the financing mechanism and medical service behavior is higher than that on the compensating mechanism and government service behavior.The farmers’ fairness perception on the system shows significant satisfaction,among which farmers’ fairness perception on the compensating mechanism influences their satisfaction most,followed by medical service behavior,financing mechanism and the government service behavior.Therefore,this paper proposes that duties of system execution department should be clarified,behaviors of the department staff should be regulated,the rationality and economical efficiency of the compensation plan should be improved and the level of basic medical services should be enhanced in order to improve the farmers’ fairness perception and satisfaction with the new rural cooperative medical system.