County-level senior high schools provide education opportunities for people living in counties or lower administrative level, which accounts for nearly half of the total population in China. The paper-setting of the college entrance examination (CEE) has a direct impact on the opportunities for county-level senior high school students to enter elite universities. This study, based on data from elite university A’s undergraduate students from 2000 to 2018, used a two-way fixed-effect model to probe into the two reforms of paper-setting of the CEE and found that in the reform of “From National to Provincial”, provincial autonomous paper-setting significantly reduced the opportunities for county-level senior high school students to enter elite universities, while it also made the distribution of admission opportunities more balanced across high schools. In the reform of “From Provincial to National”, the two methods had no significant difference. The current form of national paper-setting with sub-versions ensured a balanced distribution of admission opportunities and successfully adapted to the different education levels among different regions. Meanwhile, the implementation of targeted enrollment plan in poor areas improved the admission opportunities of elite universities for county-level high school students. Therefore, the combination of the new form of national unified paper-setting of CEE and the targeted enrollment plan in poverty-stricken areas can guarantee the equality of educational opportunities from multiple dimensions.