Objective: To investigate the incidence of abnormal spinal curvature and related factors in primary and secondary school students in the Hongkou District of Shanghai, so as to provide evidence for abnormal spinal curvature prevention and treatment. Methods: Using a stratified cluster random sampling method, 1 884 students of grade 4 to grade 12 from seven schools were investigated via questionnaires for abnormal spinal curvature in Hongkou District. Results: The detectable rate of abnormal spinal curvature was 7.2%, The detectable rate of abnormal spinal curvature increased with increasing age(P<0.01): senior high school (15.7%) > vocational high school (8.1%) > junior high school (3.4%) > primary school(1.8%)(χ 2=91.24, P<0.01). The detectable rate of spinal curvature among female students was 8.6%, which was higher than that among male students(5.9%), and the difference was significant(χ 2=5.27, P<0.05). Multivariate Logistic regression analysis showed that the factors influencing abnormal spinal curvature included phase of studying, nutritional status and time spent engaged in outdoor activities every day(P<0.05). Conclusion Abnormal spinal curvature is one of the common conditions that endangers the health of children and adolescents. The collaboration of the school, students and parents is required to strengthen screening and prevention.