Objective To quantify the potential medical preference of rural day surgery patients, and provide a policy basis for further promoting the development of day surgery in county-level hospitals. Methods Based on the discrete choice experimental design questionnaire, all rural inpatients undergoing day surgery in three departments of the First Affiliated Hospital of Fujian Medical University between September and October 2022 were selected as survey subjects, and one-to-one structured questionnaire interviews were conducted. The Mixed Logit model was used to analyze the preference size, marginal willingness to pay and average marginal effect of patients on five medical attributes and levels. Results A total of 223 copies of questionnaire were issued, and 223 valid ones were collected, with an effective recovery rate of 100%. The five medical attributes were statistically significant in the impact on the medical preference of rural day surgery patients (P<0.001), and the patient’s preference was most affected by the physician category attribute (β=1.776, P<0.001). When the medical services from experts were unavailable, patients hoped to get 4862.51 yuan in compensation; when the patients received medical services from county-level hospitals instead of higher level hospitals, patients hoped to get 3154.60 yuan in compensation; when the availability of medical equipment and drugs was low, patients hoped to get 1447.72 yuan in compensation; patients were willing to spend 1197.29 yuan more to reduce the time spent from home to hospital. When the completeness of hospital medical equipment changed from “low” to “high”, patients’ preference increased by 52.89%. Conclusion Focusing on the cultivation of health personnel and the availability of medical equipment and drugs in county-level hospitals has a positive effect on improving the development of day surgery in county-level hospitals.