Objective: To investigate the epidemiological characteristics and associated factors of scoliosis in primary and secondary school students in Guangdong, and to provide guidance for scoliosis control. Methods: Using a stratified cluster random sampling method, a total of 38 649 students aged 9-18 were selected from 132 primary and secondary schools in the Pearl River Delta and non Pearl River Delta cities for scoliosis screening and related associated factors questionnaire survey from September to October 2020. Results: A total of 1 440 students were detected with scoliosis, with a detection rate of 3.73%. The detection rate of girls was 4.90%, which was higher than that of boys at 2.66%( χ 2=386.89, P <0.01). The detection rate in the Pearl River Delta region was 4.09%, which was higher than the non Pearl River Delta region at 3.38%( χ 2=13.22, P <0.01). The detection rate in urban areas was 4.51%, which was higher than counties at 2.79%( χ 2=78.70, P <0.01). The detection rate increased with the increase of the school period, high school (5.94%)>junior high school (4.50%)>elementary school (1.35%)( χ 2=386.89, P <0.01). Multivariate Logistic regression analysis showed that region, urbanicity, gender, educational stage, exercise, using electronic mobile devices, nutritional status are the influencing factors for scoliosis ( OR=0.41-3.78, P <0.05). Conclusion The detection rate of scoliosis in primary and secondary school students in Guangdong Province varies by gender, urbanicity and educational stages. Female students, as well as junior and senior high school students should be paid more attention.