<p>The prevalence of autism spectrum disorders in children is on the rise. Medical rehabilitation resources in rural areas are relatively scarce, and rural family caregivers often bear greater pressure. This study deeply understood the pressure faced by caregivers of children with autism spectrum disorders in rural areas and their coping strategies, and provided references for improving their physical and mental health and social support system. Using purposive sampling method in qualitative research, 14 caregivers of rural autism spectrum disorder children were selected for semi-structured interviews. Colaizzi analysis method was used to summarize the topics of the interview data, and the caregivers’ stressors and coping strategies were systematically analyzed. Six themes were extracted, (a) economic pressure and lack of resources, (b) internal family conflict and emotional burden, (c) social isolation and associated stigma, (d) lack of knowledge and rehabilitation system, (e) psychological resilience and positive coping, (f) and the construction and improvement of support network. Caregivers of rural autism spectrum disorder children face multiple pressures, with heavy economic burden, obvious stigma and weak social support. It is necessary to strengthen policy implementation and resource preference, provide professional rehabilitation guidance, build a family community government collaborative support network, and pay attention to caregivers’ negative emotions to promote their positive coping.</p>