The mental health of the only-child continues to generate interest in research literature. The present study examines the issue in China, where the one-child phenomenon is highest due to deliberate government policy. Subjects are 299 and 333 students in two high-rank high schools in urban Harebin and rural Qing an Xian, respectively (mean age = 17.2 years). Both locations are in the Heilongjiang Sheng Province of China. Results showed that urban only-children experienced significantly lower love awareness from family, higher neurotic and social depression, trait anxiety, perceived stressors, and interpersonal dependency than did urban non-only children. No significant differences were found in the rural only- and non-only children. Low love awareness from parents and peers was associated with high negative mental health conditions in the children. Low love awareness also precipitated perceived stressors which resulted in negative mental health in the covariance structure analysis.