Background: Few cross-national studies have compared the relationship between socio-economic status (SES) and health among East Asian countries. This study elucidates the relationship between SES and self-rated health (SRH) in four societies of East Asia: China, Japan, South Korea and Taiwan. Methods: We used the data from the East Asian Social Survey 2006, which consists of nationally representative samples from each of the four countries. Logistic regression analysis of SRH was performed using four standardized SES indices (income, education, occupation and class identification) as explanatory variables to compare the degree of association of each SES index with SRH. Results: A total of 8120 respondents in the age range of 20-69 years were analysed. Overall, social gradients in health were observed in the East Asian societies. In China, South Korea and Taiwan, three of the four SES indices showed a statistically significant association for both male and female groups. In Japan, except class identification, no other SES index showed a significant relationship with SRH. With regard to the differences between the SES indices, class identification exhibited the strongest association with SRH, while occupational class displayed the weakest association. Conclusion: Our study results indicate that Japan has low levels of health inequality compared to other East Asian countries. Furthermore, an index of occupational classes may be insufficient to explain health inequalities in East Asia.