In order to provide basis for balanced fertilization, a total of 290 topsoil samples in Rugao were collected using GPS positioning technology and the available contents of four medium elements of calcium, magnesium, sulfur and silicon in soils were analyzed and assessed. The results showed that the average contents of exchangeable calcium, exchangeable magnesium, available sulfur and available silicon in soils were 4 570, 403, 26 and 144 mg/kg, respectively. On the whole the contents of exchangeable calcium and exchangeable magnesium were abundant but they were not evenly distributed. Available sulfur and available silicon were both deficient and excessive. Nearly 1% of the samples were deficient in silicon, and about 14% of the samples were deficient in sulfur. According to relevant literature, the contents of exchangeable magnesium and available silicon were medium variation, and the contents of exchangeable calcium and available sulfur were great variation. The correlation analysis showed that there were different correlations between the availability of four medium elements and soil pH, organic matter, total nitrogen, available phosphorus and available potassium. It can be concluded that due to the influences of soil parent material, physicochemical properties, fertilization and agricultural utilization patterns, the content variabilities of soil medium elements were large in the whole city. In the future, more attentions should be paid to the reasonable application of medium element fertilizers to realize balanced fertilization.