Objective: To analyze and assess the current status of high blood pressure and associated factors among primary and secondary school students in Xinjiang in 2023, so as to provide a scientific basis for prevention and control decision making of high blood pressure among students. Methods: From September to November 2023, a total of 94 205 primary and secondary school students aged 8-17 from 14 prefectures and cities in Xinjiang, were selected for physical measurement and questionnaire survey using a stratified clustering random sampling method. The χ 2 test was employed to compare differences in high blood pressure rates among students with varying characteristics. Additionally, a Logistic regression model was developed to analyze associated factors with high blood pressure among primary and secondary school students. Results: The overall high blood pressure rate among primary and secondary school students in Xinjiang was 8.18%, with simple systolic hypertension being the main type at 52.16%. By educational stages, high blood pressure rates for elementary school (grades 4-6), middle school, high school and vocational high school were 8.04%, 8.59%, 7.65%, and 9.72% respectively ( χ 2=29.16, P <0.01). The high blood pressure rates among obese and overweight students were 9.93% and 17.88% respectively, significantly higher than 5.32% among normal weight students ( χ 2=1 643.14, P < 0.01 ). The high blood pressure rate among urban students (8.73%) was higher than that of rural students (7.15%) ( χ 2=71.58, P <0.01). Logistic regression model analysis showed increased high blood pressure risk for girls than boys ( OR = 1.06 ); middle school, high school, and vocational high school students had increased high blood pressure risk compared to elementary school students ( OR =1.22, 1.16, 1.70); rural students had lower high blood pressure risk than urban students ( OR =0.90); the risk of high blood pressure in overweight and obese groups was higher than that in the normal group ( OR =1.54, 3.00), and the risk of high blood pressure in boarding students was lower than that in non boarding students ( OR =0.71)( P <0.01). Conclusions In Xinjiang in 2023, primary and secondary school students have a certain rate of high blood pressure, mainly characterized by elevated systblood pressure lower. The main prevention and control targets are females, urban residents, those in higher academic stages, non boarding students, as well as overweight and obese primary and secondary school students.