Objective: To analyze the incidence of adenoid hypertrophy and risk factors for secretory otitis media among primary and middle school students aged 7-16 years in Suzhou,and to provide a reference for its clinical disagnosis,treatment and prognosis. Methods: The primary and secondary school students aged from 7 to 16 in Suzhou from January 2015 to December 2019 were selected by using cluster stratified sampling, adenoid hypertrophy cases were screened and diagnosed by MR, the epidemiology of adenoid hypertrophy and related risk factors of complicated secretory otitis media were analyzed among participants. Results: Among 327 cases of adenoid hypertrophy were screened, with a prevalence rate of 10.95%. From 2015 to 2019, the prevalence rate of adenoid hypertrophy among primary and middle school students increased by year. The prevalence rate in 2019 was 10.95% higher than 9.20% in 2015 and 9.95% in 2016. The prevalence rate of adenoid hypertrophy in boys was 12.29%, which was higher than 9.48% in girls( χ 2=6.04, P <0.05). The prevalence rate of adenoid hypertrophy between 7-10 years old was 15.08% and higher than 6.36 %( χ 2=57.93, P <0.05) for primary and middle school students aged 11-16. Among the 327 primary and middle school students with adenoid hypertrophy,a total of 20 had secretory otitis media, and the combined rate was 6.12%. The age of the combined secretory otitis media group was younger than that of the non combined group, the severity of adenoid hypertrophy was higher than that of the non combined group, and serum IL-4, TNF-α, IgA, IgG, and IgM were higher than those of the non combined group ( P <0.05). Adenoid hypertrophy complicated with secretory otitis media was associated with age, severity, IL-4, IgG, and IgM ( P <0.05). Conclusion The prevalence of adenoid hypertrophy among primary and secondary school students aged 7-16 years in Suzhou is relatively high, which is related to gender, age, time of onset and season. Secretory otitis media in adenoids hypertrophy children and adolescents should attract sufficient attention from the whole society.