Objective: To analyze the prevalence and associated factors of suicide ideation among adolescent students in Guizhou Province, and to provide scientific evidence for developing strategy. Methods: Multistage stratified cluster sampling method was used to recruit 4 903 adolescents from 14 middle schools in Guizhou Province. China Youth Health Risk Behaviors Questionnaire was used and data were analyzed by using univariate analysis and Logistic regression analysis. Results: Totally 14.3%(703/4 903) middle school students had suicide ideation during the past 12month period, in which 13.2% were boys and 15.4% were girls, more girls were prone to suicide than boys(χ2=5.20, P<0.05); 13.7% junior students, 15.0% senior students, 14.5% Han ethnic students and 14.1% minority students suicide ideation, and the differences between grades and ethnic groups were of no statistical significance (P>0.05). The multivariates Logistic regression analysis showed that risk factors for suicidal ideation included being girl(OR=1.49),higher maternal education(college and above: OR=2.26), suffering psychological bullying over the past 30 days(OR=1.30), taking part in fighting for the past 12 months (OR=1.33), often feeling lonely(OR=1.86), sleeplessness(OR=1.38), deliberate selfinjury(OR=3.58),decreases of daily activities due to depression(OR=1.87), ideation of running away(OR=3.31), internet addiction(OR=1.37), walk violating regulations(OR=2.42), but occasional low mood from academic pressure(OR=0.73) was a protective factor for suicidal ideation(P<0.05). Conclusion Suicide ideation of middle school students is closely related to campus violence, adverse inner metal experience and unhealthy behavior pattern. All sectors of society should attach great importance and targeted measures to prevent suicide and protect the students.