Objective: To investigate the prevalence of anemia and its influencing factors among primary school students from Kazakh ethnic groups in agricultural and pastoral areas of Altay Prefecture, Xinjiang Uygur Autonomous Region, so as to provide insights into improvements of nutrition and prevention of anemia among students. Methods: Grade 1 to 3 Kazakh ethnic students were sampled using a cluster sampling method from 7 primary schools in agricultural and pastoral areas of Altay Prefecture, Xinjiang Uygur Autonomous Region from April to June, 2022. Demographics and dietary behaviors were collected using questionnaire surveys, and the height and body weight were measured, while peripheral blood hemoglobin was detected. Factors affecting anemia were identified using a multivariable logistic regression model. Results: A total of 2 378 questionnaires were allocated, and 2 214 valid questionnaires were recovered, with an effective rate of 93.10%. The respondents included 1 123 men (50.72%) and 1 091 women (49.28%), and had a mean age of (8.12±1.41) years. The prevalence of anemia was 22.49%, and the detection rates of mild and moderate anemia were 15.31% and 7.18%, with no severe anemia detected. Multivariable logistic regression analysis identified frequency of eating eggs (0, OR=2.532, 95%CI: 2.114-3.015; 1 to 3 times/week, OR=1.926, 95%CI: 1.648-2.216), frequency of eating meat (1 to 3 times/week, OR=1.468, 95%CI: 1.256-1.689; 4 to 7 times/week, OR=2.212, 95%CI: 1.823-2.641), frequency of healthy check-up (0, OR=2.872, 95%CI: 2.523-3.231; 1 time/year, OR=1.826, 95%CI: 1.546-2.108), monthly mean household income (1 500 Yuan and lower per month, OR=1.324, 95%CI: 1.071-1.582; 1 501 to 3 000 Yuan per month, OR=1.124, 95%CI: 1.029-1.221) and caregiver (grandparents, OR=1.175, 95%CI: 1.038-1.324; others, OR=1.241, 95%CI: 1.032-1.466) as factors affecting anemia. Conclusions The prevalence of anemia is 22.49% among primary school students from Kazakh ethnic groups in agricultural and pastoral areas of Altay Prefecture, Xinjiang Uygur Autonomous Region, with mild anemia as the predominant type. Dietary behaviors, frequency of healthy check-up, economic status and caregiver may affect the development of anemia.