Based on valid questionnaire data of 2?110 rural adult children, this study investigates the characteristics of spiritual filial support behavioral patterns among rural adult children, as well as the associative mechanisms of childhood left?behind experience and alexithymia with these patterns. The results reveal that spiritual filial support behaviors of rural adult children can be classified into three patterns: high?quality supportive, growth?empowerment?lagged, and alienated. Significant differences in parental well?being exist across patterns (high?quality supportive > growth?empowerment?lagged > alienated). Relative to the alienated pattern, childhood left?behind experience is significantly negatively correlated with the probability of adult children being categorized into the two higher?level spiritual filial support patterns (high?quality supportive and growth?empowerment?lagged). Further analyses show that alexithymia exhibits significant partial mediating associations between childhood left?behind experience and each of the two higher?level spiritual filial support patterns. It is suggested to improve the support system for rural family spiritual filial support, prioritize interventions targeting empathy and emotional?expression abilities among individuals with left?behind experience, and optimize the supply of spiritual filial support for this group.