Objective: To understand sexual and reproductive health (SRH) knowledge and access to sexual health information among pupils in higher grades, and to provide the scientific basis for conducting sexual education in family and school. Methods: A total of 1 098 pupils in grade four and five from 4 primary schools in a county, Jiaxing City, Zhejiang Province were selected for an anonymous computer assisted self-interview to get the information, including sexual and reproductive information and its sources, the condition about getting sexual education from school and family, and so on. Results: The percentage of correct answers about boy’s and girl’s puberty changes ranged from 15%~54%, and about reproduction and physiology ranges from 14%~70%. The awareness of private body parts ranged from 59%~98%. About 70%~95% could correctly identify sexual abuse scenes. The average score for knowledge on puberty changes, reproduction and physiology, identification of private body and identification of sexual abuse scenes was 31.89, 38.21, 77.03, and 85.72, with total average score of 58.21. In general, girls and students from urban areas or in grade five had higher knowledge level than boys and students from rural areas or in grade four did (P<0.05). Participants mainly obtained SRH knowledge from their mother(63.02%), father(40.53%) and teachers(27.50%). Girls and students from urban areas or in grade five reported higher proportion in access to information on human development, puberty development and health care, self-protection from parents and school teachers than boys and students from rural areas or in grade four(P<0.05). Conclusion Pupils in higher grades lacked SRH knowledge. It is necessary to raise awareness among school teachers and parents about the importance of providing sexuality education for pupils.