Objective: To analyze environmental and health literacy and associated factors of medical students in Gansu Province, and to provide reference for targeted environmental and health education. Methods: The questionnaire was designed based on the "core questions of citizen environmental and health literacy assessment" in the technical guide for citizen environmental, and demographic characteristics were added appropriately. The stratified cluster sampling method was used to selecte 6 619 medical students in Gansu Province as respondents. Results: The proportion of medical students in Gansu Province with environmental health literacy was 5.7%. The proportions of basic literacy, basic knowledge, and basic skills were 14.2%, 1.8% and 40.4%,respectively. Medical students of different genders, nationalities, majors and age had different levels of environmental and health literacy and three types of classification literacy, all of which showed that the rate of boys were higher than girls, the rate of han students were higher than minority students, the rate of preventive medicine students were higher than that of other majors, and an increasing trend was found with the increase of age(P<0.05).The environmental and health literacy level and basic concept literacy level of medical students at different professional levels also showed an increasing trend(P<0.05). Multivariate Logistic regression analysis showed that the factors affecting medical students’ environment and health literacy included gender, nationalities, majors and professional levels(OR=0.68, 0.66, 0.30-2.83, 0.18, P<0.05). Conclusion The environmental and health literacy of medical students are generally low, especially in terms of basic knowledge of environment and health. Comprehensive health education regrading environment and health literacy should be carried out in colleges to increase awareness and knowledge among future education leaders.