<p>The challenges faced by rural family caregivers of infants have a profound impact on their early development. To exploring the challenges and support needs of infant caregivers in rural areas of China, this qualitative study conducted in-depth interviews with 11 caregivers (including 7 grandmothers, 1 grandfather, and 3 mothers) of infants from five rural areas in Jiyuan City, Henan Province, between July 2022 and January 2023. Data was collected using a semi-structured interview guide (comprising 12 questions) prepared by the researchers. The data was analyzed using a directed content analysis approach based on the Social Ecological Systems Theory. The results indicated that caregivers faced multiple challenges at the micro-, meso-, and macrosystem levels. At the micro level, caregivers confronted physical and mental health challenges because their daily routines were arranged around child-rearing, and they relied heavily on traditional methods. Issues such as poor family economic conditions, a lack of internal family support, and conflicts in intergenerational parenting concepts were prominent at the mesosystem level. Challenges at the macro level included inadequate community environments, inadequate support systems, traditional parenting beliefs, and insufficient parenting information. Recommendations include enhancing family communication, community support, parenting education, and welfare-based caregiving services, as well as increasing government investments in healthcare, education, infrastructure, and caregiver subsidies. This study offers a new perspective for understanding the ecosystem complexity of rural infant caregivers and provides a basis for formulating precise and effective support strategies.</p>