Objective: To understand environmen and sanitation of rural schools in western China, and to provide data support and reference for improving school environmental conditions and facilities and promoting the healthy development of students. Methods: Based on the "School Comprehensive Environmental Improvement Project", a total of 38 087 students from 60 primary school from were randomly selected from 5 provinces in western China from September to December 2018. Environment and sanitation of schools was investigated through interviews, on site observation and inquiry, so as to obtain the survey data. Results: All schools had water supply, 80.0% (48) could meet the needs of teachers and students, 91.7% (55) provided drinking water facilities, 93.3 % (56) provided hand washing facilities, and 66.7% (40) provided soap and other cleaning supplies for students. 71.7% (43) of the schools had sanitary toilets, 40.0% (24) toilets were qualified for femail, 86.7% (52) were clean and 58.3% (35) were odorless. The garbage disposal methods of schools are mainly collected by professional institutions, supplemented by fixed point stacking, accounting for 45.0% (27) and 35.0% (21) respectively. About 30% (22, 17, 20) of school sewage is discharged by open ditch, underground ditch and pipeline. 93.3% (56) of schools offered health education courses, 91.7% (55) had sanitation system, 70.0% (42) had drinking water sanitation management system, and 41.7% (25) had toilet management system. Conclusion The basic environmental sanitation facilities in the school are well equipped, and there are some problems to be improved in the establishment of environmental sanitation management system and the provision of hand washing and cleaning supplies.