Objective: To investigate the relationship between childhood abuse experience and non-suicidal self-injury in middle school students, and gender differences of the relationship. Methods: Stratified cluster sampling method was used to select 14 500 middle school students from Shenzhen, Zhengzhou, Nanchang and Guiyang as participants. Questionnaire survey was conducted to collect information on demographic indicators, childhood abuse experiences and non-suicidal self-injury, etc. Logistic regression was used to analyze the relationship between childhood abuse experience and non-suicidal self-injury, and gender differences. Results: The prevalence of NSSI was 9.5%,while it was higher among male students (10.7%) than female students(8.3%) (χ2=22.77，P<0.01). The rate of NSSI was higher with the increasing exposure of childhood abuse. High levels of multiple forms of childhood abuse had independent effects on NSSI among total samples after controlling for confounding factors (P<0.01). In middle school students with high levels of sexual abuse, emotional neglect and childhood abuse, females versus males had higher risk to have NSSI (P<0.01). Conclusion Childhood abuse experiences were associated with increased risk of NSSI among middle school students, especially among girls. Groups at highest risk of NSSI in relation to certain types of childhood abuse should be targeted with interventions accordingly.