Students in rural China are dropping out of secondary school at troubling rates. While there is considerable quantitative research on this issue, no systematic effort has been made to assess the deeper reasons behind student decision-making through a mixed-methods approach. This article seeks to explore the prevalence, correlates and potential reasons for rural dropout throughout the secondary education process. It brings together results from eight large-scale survey studies including 24,931 rural secondary students across four provinces as well as analysis of extensive interviews with 52 students from these same study sites. The results show that cumulative dropout across all windows of secondary education may be as high as 63%. Dropout is significantly correlated with low academic performance, high opportunity cost, low socioeconomic status and poor mental health. A model is developed to suggest that rural dropout is primarily driven by two mechanisms: rational cost-benefit analysis or impulsive, stress-induced decision-making.