Abstract: Objective To explore and study the incidence of refractive error among primary and secondary school students in Xuzhou City, and to understand the related factors of myopia, so as to provide theoretical reference for the prevention and treatment of myopia. Methods stratified cluster sampling method was used to select 2 primary schools, 2 junior high schools and 2 senior high schools in Xuzhou from September 2019 to October 2019. A total of 1 321 students in 2 classes were randomly selected from each school as the research objects, and visual screening and questionnaire survey were conducted. SPSS 19.0 statistical software was used to process and analyze the data, and the related factors affecting visual acuity were summarized. Results Total 1 321 students received valid questionnaires in 1 312 cases. The incidence of hyperopia was 1.52%, strabismus 0.61%, amblyopia 1.60% and myopia 45.96%. The survey showed that children and parents had low awareness and protection awareness of vision problems, family history, daily homework and reading time of more than 8 h, use of electronic products for more than 3 h, and incorrect posture of writing and holding pen were the influencing factors of myopia(all P<0.05). Conclusion Children and parents in Xuzhou have low awareness of vision problems and low awareness of protection. Parents and students have low awareness of knowledge related to vision protection, and there are some adverse factors that may cause myopia, such as excessive use of eyes. Some students are not clear about the influence of myopia on body and mind and the prevention and treatment measures. With the increase of grade, it is gradually clear that myopia has some adverse effects on body and mind. The incidence of myopia is high among primary and middle school students, so it is necessary to identify the risk factors of myopia in a timely manner, formulate relevant measures for students, develop good habits of using eyes, and promote visual health care.