Spousal bereavement is closely linked to prolonged grief, that is, signi ？ cant adjustment symptoms that last for more than six months after the loss. This article focused on potential risk and protective factors that may in ？ uence bereavement outcomes. Participants in this study were surviving spousesf individuals who died of acquired immune de ？ ciency syndrome (AIDS). These participants were themselves living with human immunode ？ ciency syndrome. In this cross-sectional study, 120 bereaved participants completed measures of grief, quality of dying and death of the deceased, negative conceptions of death resulting from AIDS, death attitudes, and personal resilience. The results showed that one-third (35.0%) of the bereaved participants reported grief levels above the prolonged grief cut-off scores, and can be categorized as the “ prolonged grief ” group. Although quality of dying and death was not associated with the intensity of grief, negative conceptions of death from AIDS, fear of death and resilience independently predicted grief symptoms in the regression models. Our ？ ndings provide insight into the grief process for the surviving spouse of AIDS victims in rural China. Since resilience is malleable, developing resilience interventions to enhance adjustment to bereavement may be a promising direction in grief counselling and therapies.