Objective: To analyze the prevalence and associated factors of hypertension among primary and secondary school students aged 9-18 years in Henan province, and to provide scientific evidence for targeted hypertension prevention strategies. Methods: Data of 34 840 students aged 9-18 years with physical examination and questionnaire information came from National School Student Physical Fitness and Health Survey in 2014. Results: The prevalence of hypertension among primary and secondary school students aged 9-18 years in Henan Province was 11.5%. The prevalence of boys and girls was 13.1% and 9.9%, respectively, and boy’s was higher than girl’s (χ2=89.04, P<0.01). The prevalence of primary school, junior high school and senior high school was 13.0%, 12.1% and 9.2%, respectively, and primary school was higher compared with junior and senior high school (χ2=89.66, P<0.01). Binary logistic regression analysis showed that high BMI (OR=1.97), eating eggs every day (OR=1.11), attending more physical education classes every week (OR=1.16), doing more setting-up exercises during the break (OR=1.08) and playing electronic products for longer time (OR=1.09) were positively associated with risk of hypertension (P<0.05). While longer sleep time (OR=0.83) and more serious attitude toward setting-up exercises during the break (OR=0.91) were negatively associated with risk of hypertension (P<0.05). Conclusion The study documents a high prevalence of hypertension among primary and secondary school students in Henan Province, which is associated with multifarious factors. Therefore, effective prevention and control measures should be taken for different populations to prevent high blood pression.