Objective: To understand associated factors of myopia among middle school students in Zhengzhou and to explore the correlation between myopia with overweight and obesity, to provide a scientific basis for myopia prevention. Methods: A total of 3 297 middle school students from 8 middle schools in Erqi District, Zhongmu County and Xingyang County of Zhengzhou City were selected by a cluster random sampling method to participate in vision testing and questionnaire survey. Chi square test, and Logistic regression analysis were used. Results: Overall prevalence of myopia of middle school students was 80.5%, overweight 14.7%, obesity 10.1% in Zhengzhou. The prevalence of myopia differed significantly by schooling stage, parental myopia status and sex ( χ 2= 18.34, 23.55, 8.98, 26.53, 27.46, 47.25, P <0.05). Significant differences in myopia detection rate by after school homework duration were observed in boys and the entire population( χ 2=12.40, 15.25, P <0.01), and significant differences in myopia detection rate by body mass index (BMI) were only observed in boys ( χ 2=6.32, P <0.05). The distribution of myopia severity was statistically significant by sex among junior school students, and by BMI categories among high school students ( χ 2=22.71, 20.37, P <0.01). Multivariate binary Logistic regression analysis showed that the risk for myopia among school students who were overweight and obese was 1.81 times higher than that of students who were not overweight and obese( P <0.01). Conclusion Overweight and obesity might increase the risk of myopia among middle school students, targeted measures should be taken to maintain the healthy weight of middle school students and reduce the risk of myopia.