Abstract: Background: Health burden in rural areas of developing countries is worsened by the limited coverage of health insurance. With constrained access to quality healthcare and constituting two thirds of Nigeria's poor, this study investigates how rural households cope with health shocks consequent on their socioeconomic status. Method: Data was collected from 600 households in Enugu using a questionnaire. Cross-tabulation, chi square and multiple regression statistical techniques were employed for data analysis. Findings: About 53% of the respondents were male household-heads while borrowing (47.65%), sales of assets (43.85%), diversion of funds (2.00%) and reduced expenditure (6.48%) were the main coping strategies. Education, occupation, and income statistically influenced the coping strategies (P < 0.005) and jointly accounted for 26.5% (R2 = 0.265, P < 0.00 I) of the variations in coping strategies. Conclusion: Having a rural healthcare policy and mainstreaming the informal sector into the national health insurance scheme will ameliorate health shocl‹s among the rural poor. Keywords: Health Shocl‹s, Coping Strategies, Socioeconomic Status, Rural Households, Healthcare Expenditure, Enugu State, Nigeria