Objective: To understand the characteristics of injuries among rural children, and to determine the relationships between school-level factors with anxiety among injury-prone children, to provide a reference for making effective measures to prevent and control the injuries. Methods: A cross-sectional survey was conducted in the Qingxin District of Qingyuan City. Six primary schools and middle schools were randomly selected from two towns. A total of 5 250 students in grades 3-9 were investigated. Students filled out the questionnaire themselves. Screen for Child Anxiety Related Emotional Disorders (SCARED) was used to assess anxiety. Results: Among the 770 rural children who suffered injuries during the past year, the leading cause of injury was falling(44.62%), falling at home(29.61%), getting injuried in low limbs(29.45%), getting injuried by oneself (41.00%) and mainly unintentional injuries(68.66%) . About 35.06% of children reported anxiety symptoms. Approximately 14.94% of children were injury-prone type. Significant differences in educational stage, boarding school, fighting involvement, and somatization/panic between injury-prone children were found in control group(P<0.05). The robust Poisson-GEE model showed that primary school students in high grade and middle grade, fighting with classmates, somatic/panic associated with injury risk (PR value was 2.11, 1.75, 1.58 and 1.58, respectively). Conclusion Injury-prone children in rural are affected by school-level factors as well as anxiety symptoms. In addition to safety education, mental health promotion and prevention of school bullying should be adopted in schools.