Objective: To explore the prevalence and associated distress of lower urinary tract symptoms among female college students in Xuzhou. Methods: Convenience sampling was used to recruit 1 000 female college students in Xuzhou China. Chinese versions of International Consultation on Incontinence Questionnaire LUTS and General Information Questionnaire was used. Results: The prevalence of lower urinary tract symptoms was 95.7%. The top ten prevalence rates were urgency (88.2%), hesitancy (65.4%), nocturia (48.5%), intermittent stream (47.3%), straining (30.5%), increased daytime frequency (30.1%), bladder pain (21.0%), SUI (18.5%), UUI (13.9%), nocturnal enuresis (7.5%). Urinary urgency was the most disturbing symptom (49.0%). Risk factors of urinary urgency included rural household registration (OR=1.67, 95%CI:1.10-2.55, P=0.017) and premature urination (OR=1.65, 95%CI:1.23-2.21, P=0.00). Conclusion Female college students have a high prevalence of lower urinary tract symptoms but with moderate severity and distress. Toileting behaviors affect bladder health, which require early intervention.