BACKGROUND: Shifts in women's maternal roles may contribute to the global low prevalence of exclusive breastfeeding. RESEARCH AIM: To investigate the association between maternal gender-role ideologies and exclusive breastfeeding in rural China. METHODS: Cross-sectional studies were conducted in 10 counties in Shaanxi Province using random sampling in 2021 and 2023. Data on breastfeeding practices, maternal gender-role ideology, and expected educational attainment from 586 rural participants were collected through structured questionnaires. Multivariable regression analysis was employed to explore the association between maternal gender-role ideology and exclusive breastfeeding. RESULTS: The prevalence of exclusive breastfeeding within 6 months in rural western China was 18.8%. Women with more egalitarian gender-role ideologies were more likely to engage in exclusive breastfeeding ( CONCLUSION: Maternal gender-role ideology positively correlates with exclusive breastfeeding. More policies should be implemented on gender equality in rural China, and cultural perspectives should be incorporated into the analysis of breastfeeding practice.