To modernize health care in China, much emphasis is currently being put on the in-service training for the remaining group of its medical paraprofessionals known as the "barefoot doctors". They have functioned differently from the conventional professional physicians. They were farmers, yet they took care of the primary health care needs in their communes even without proper medical education. The manner in which they trained and practiced their profession as barefoot doctors was a unique modality of China's health care system during the Cultural Revolution. When the revolution ended, the economic reforms placed the barefoot doctors in a bad light. They were negatively perceived and their credibility as health care workers continued to be a major health management issue since the barefoot doctors reflected the strong ideals of the revolution. Despite this criticism from central government and the general public, their professional growth has been encouraged because of the insufficiency of local physicians who can 1 provide appropriate health care for the rural peasants. This study describes their historical evolution in the paraprofessional medical manpower development of China, to explore further directions of primary health care in contemporary China.