Providing sustainable energy access is one of the most critical global challenges. This paper introduces a method for evaluating the status and progress of rural household energy sustainability in developing countries using a new composite indicator, the energy sustainability index (ESI). The ESI combines 13 techno-economic, environmental and social indicators of sustainability using principal component analysis (PCA). We apply the ES! to China, India, South Africa, Sri-Lanka, Bangladesh and Ghana between 1990 and 2010. The analysis suggests that South Africa's rural energy sustainability index is highest followed by China, Sri Lanka, India, Bangladesh and Ghana respectively. All the countries' rural energy sustainability has improved relatively over time except Ghana's. Improvements result mainly from increasing rural electricity use and increasing access to clean and efficient cooking fuels.