Objective : This study aimed to uncover socioeconomic variations in the prevalence and patterns of noncommunicable disease (NCD) multimorbidity including seven common chronic conditions, and to investigate its association with depression symptoms. Methods : A cross-sectional survey was conducted including 7509 adults aged >= 35 years in rural Yunnan Province, China from 2023 to 2024. Association rule mining was used to identify the NCD multimorbidity patterns of seven common chronic conditions. Multivariable logistic regression analysis was employed to examine the relationship between NCD multimorbidity and depression symptoms. Results : The prevalence of NCD multimorbidity was 18.8 %. NCD multimorbidity was more prevalent among participants with lower education, lower annual household income, and better access to medical care (P < 0.05). NCD multimorbidity and their patterns of chronic obstructive pulmonary disease + asthma, diabetes + coronary heart disease, hypertension + stroke, and hypertension + coronary heart disease + diabetes were associated with a greater risk of depression symptoms (P < 0.05). Conclusions : There are socioeconomic disparities in prevalence and patterns of NCD multimorbidity across rural southwest China. NCD multimorbidity was positively associated with depressive symptoms. Future measures to prevention NCD multimorbidity should be strengthened and targeted at lower socioeconomic populations, with greater focus on managing depression in NCD multimorbid patients.