Abstract: Faced by disparities in the fast-growing economy and the institutional weaknesses of public healthcare, poorer people in rural China have struggled to obtain effective health treatment. Christianity has played an important role in identifying and redefining the nature of this problem. The fieldwork for this article was conducted in and around a village church in eastern Henan in central China during 2012–13. The article argues that when poorer villagers’ expectations of treatment encountered the special features of Christianity and its localisation in China, a mixture of cultural idioms was created through the process of Christian conversion that furnished the rural poor with new models for treatment. The spread of Christianity as related to illness treatment in rural China thus cannot be reduced to utilitarian logic for it entails the re-imagination of illness and of the nature of the healthcare system.