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Background: Major depressive disorder (MDD) is a common psychiatric disorder which is associated with significant disability and psychosocial factors. There are only few epidemiological studies of MDD in economically underdeveloped regions of China. This study examined the 1-month and lifetime prevalence of MDD and their sociodemographic correlates in Hebei province, China.Methods: Using multistage, stratified and random sampling, the study was conducted between April and August 2016. The diagnosis of MDD was established using the Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Edition.Results: The weighted 1-month and lifetime prevalence of MDD were 0.9% (95%CI: 0.8-1.1%) and 1.6% (95%CI: 1.4-1.8%), respectively in the sample of 14,654 adult participants. Multiple logistic regression analysis revealed that the age group of 45-59 years (P < 0.001, OR=3.206, 95%CI:1.693-6.072), female gender (P < 0.001, OR=2.171, 95%CI: 1.522-3.097), married marital status (P < 0.001, OR=0.328, 95%CI: 0.198-0.545), college educational level or higher (P = 0.006, OR=0.145, 95%CI: 0.037-0.573), employment (P = 0.010, OR=2.305, 95%CI: 1.220-4.353), major medical conditions (P < 0.001, OR=3.758, 95%CI: 2.607-5.418) and family history of psychiatric disorders (P < 0.001, OR=3.947, 95%CI: 2.203-7.071) were significantly associated with MDD.Conclusion: The prevalence of MDD in Hebei province was found to be lower than in most areas of China and other countries. Further studies are warranted to confirm the low prevalence of MDD in other economically underdeveloped regions of China. [ABSTRACT FROM AUTHOR]