OBJECTIVE In China's Nong Zhuan Fei (NZF) communities, farmers living in rural villages are uprooted and moved into newly constructed urban apartments when the government purchases their land for residential and commercial development. With their relocation from a traditional rural setting to a modern urban setting, residents of NZF communities face lifestyle-based risk factors for diabetes and other chronic diseases. We reported estimates of diabetes prevalence, risk factors, and health-related quality of life among adult Chinese NZF rural-to-urban migrants. METHODS We conducted a descriptive cross-sectional study through a U.S.-China partnership with an NZF community of 3,184 residents. Health and disease history, risk factors, and sociodemographic information were collected by questionnaire. Participants completed a 24-hour diet recall, three-day physical activity recall, a health-related quality of life Short-Form 36 (SF-36) health survey, the Beck Depression Inventory, and fasting blood glucose tests. RESULTS We gathered complete data from 1,150 of 1,772 eligible participants. The prevalence of diabetes was 11.6% (95% confidence interval 9.8, 13.6). Diabetes risk increased significantly with age, income, obesity, and hypertension. Based on SF-36 scores, residents aged ≥60 years with diabetes reported significantly greater physical (47.7 v. 70.2, p=0.001) and emotional (76.9 vs. 89.7, p=0.006) limitations, more bodily pain (79.7 vs. 84.9, p=0.021), and worse overall physical health (67.6 vs. 76.0, p=0.015) than those without diabetes. CONCLUSION The Chinese government hopes to integrate an additional 250 million people into city living by 2025. As the NZF population increases, so may the prevalence of diabetes associated with the change from a rural to an urban lifestyle. Action is needed now by public health professionals to prevent a possible diabetes crisis in NZF communities in the future.