Objective To understand the prevalence of Clonorchis sinensis infection in Xinfeng County, so as provide scientific basis for formulating control strategies. Methods The Xinfeng County was divided into 5 areas according to the geographical location, and in each area one village was selected from a township to serve as the surveillance site, including Yu Village of Gubei Town, Zhangtang Village of Datangbu Township, Zhengao Village of Zhengping Township, Huangni Village of Xiniu Township, and Jiaokeng Village of Jiading Township. During 2016 to 2019, no less than 200 permanent residents aged 3 years or above were cluster sampled from each administrative village each year for fecal examination using the modified Kato-Katz thick smrar method (two slide reading/one sample) to estimate the status of Clonorchis infection. In addition, no less than 150 examinees were randomly selected for questionnaire survey on the knowledge, attitude and behavior towards clonorchiasis. Comparison of infection rate between groups was analyzed by chi-square test. Results From 2016 to 2019, the infection rate of C. sinensis was 9.3% (96/1 027), 8.9% (89/1 005), 5.2% (52/1 000) and 6.4% (64/1 002), respectively in each year, and the youngest infected people was at the age of 3, 11, 26 and 27 years, respectively. The infection rate in males was higher than that in females (P < 0.01). No infection was found in preschool children except in 2016, while the infection occurred in all other groups of different education levels in all years. The questionnaire survey indicates that from 2016 to 2019, the proportions of residents eating raw fish was 14.4% (22/153), 16.6% (25/151), 9.3% (14/150) and 18.8% (29/154), respectively. The proportion of residents having heard of clonorchiasis increased from 13.7% (2/153) in 2016 to 55.8% (86/154) in 2019. Conclusion The infection rate of C. sinensis remains high in the national surveillance site in Xinfeng County, and the proportion of residents eating raw fish keeps persistent in the four years.