Objective: To explore the epidemiological characteristics and influencing factors of abdominal obesity among primary and middle school students in Hangzhou, and to provide evidence for abdominal obesity prevention. Methods: A total of 27 967 students from 711 classes 23 primary and middle schools in 4 districts and 5 counties in Hangzhou were investigated. The 90th percentile (P90) of waist circumference of the same ethnicity, age and gender was used as the diagnostic value for abdominal obesity. Chi-square test was used to identify the deference among groups. Multilevel analysis was applied on the influencing factors of abdominal obesity. Results: The rate of abdominal obesity among primary and middle school students in Hangzhou was 17.69%, with urban (20.98%) higher than rural (15.61%), boys’ (20.40%) higher than girls’ (14.92%), highest in primary school students (20.83%) and lowest in high school students (15.30%). The effects of school and class on abdominal obesity among primary and middle school students were significant (P<0.01). The rate of abdominal obesity among primary and middle school students in Hangzhou was higher than national average level. In addition to the individual factors, management on healthy food and nutrition should be a high priority on every class and every school.