Objective: To explore the association between parents health literacy and health risk behaviors of middle school students, so as to provide theoretical basis for parental health literacy improvement and adolescent health risk behaviors prevention. Methods: A questionnaire survey was conducted among 1 993 middle school students and their parents in northeast Jiangxi Province by multistage stratified random sampling during Jun. to Sept. of 2020. Spearman correlation and generalized linear model were used to explore association between parents health literacy with 5 types of unhealthy behaviors. Results: Generalized linear model analysis showed that after adjusting household economic status and other covariates, parents health literacy was associated with adolescent health risk behaviors, and the scientific health view ( β =-0.05, 95% CI =-0.09--0.01), health information literacy ( β = -0.06 , 95% CI =-0.08--0.05) were associated with substance abuse and violence among middle school students; health information literacy ( β =-0.03, 95% CI =-0.04--0.01) was associated with adolescent healthy eating behavior; health information literacy ( β =-0.03, 95% CI =-0.05--0.02) was associated with breakfast and exercise in middle school students; chronic disease literacy ( β =0.05, 95% CI =0.00-0.09), health information literacy ( β =-0.02, 95% CI =-0.03--0.00) was associated with screen related behavior of middle school students; scientific health view ( β =-0.05, 95% CI =-0.09--0.01), basic medical literacy ( β =-0.08, 95% CI =-0.13--0.04), health information literacy ( β =0.02, 95% CI =0.00-0.03) were associated with middle school students traffic safety behavior( P <0.05). Conclusion There is a certain cross sectional correlation between parents health literacy and adolescent health risk behaviors. It is necessary to clarify the direction and intensity of the correlation in the cohort study.