Air pollution in Chinese cities has become a major topic of public debate and political concern. At the same time, few rural areas are subjected to measurements of ambient air quality, and policy documents and media rarely discuss the health and environmental risks caused by household air pollution (HAP) produced by the use of biomass for cooking and heating. Between 2014 and 2017 a cross-disciplinary team carried out a joint study of air quality and perceptions of air pollution in one of China’s richest provinces, Zhejiang. We found that the ambient PM2.5 concentration in the rural villages was similar to that in the urban areas. Moreover, the 24-hour mean personal exposure to particulate pollution (PM2.5) was similar for urban and rural participants in total. However, we found indications of enhanced exposure levels in certain sub-groups, such as biomass users, women, and family cooks. We found that while villagers were strongly concerned about risks of air pollution coming from nearby factories, they were largely unaware of the problem of HAP. In this article, we analyse to what extent HAP contributes to the air pollution exposure in the areas studied, and we discuss possible reasons why it has largely remained a hidden hazard. In the conclusion, we suggest that air pollution in rural areas should receive more attention from media, environmental organizations and policy makers; furthermore, that HAP in particular should be incorporated into air pollution policies to a greater extent, and its contribution to air pollution exposure in rural areas be made more publicly known.