Objective: To analyze dental caries and associated factors among primary and middle school students in Henan Province, so as to provide reference for dental caries prevention and control. Methods: The data of physical health survey of students in Henan Province in 2019 was analyzed for caries and other related index of students aged 7, 9, 12, 14 years. Chi square test was used to compare detection rate of caries by sex and residence, analysis of variance was used to compare the height between with and without risk of caries, and Logistic regression analysis was conducted for the influencing factors of caries. Results: The caries rate was 56.6%. And the male students (53.4%) was lower than the female students (59.7%). The urban students (53.4%) was lower than the rural students (59.8%)( χ 2=52.31,54.00, P <0.01). The height of the caries free group was higher than that of the caries group, and the height difference was 0.5-1.6 cm; the prevalence of caries decreased with the increase of age( χ 2=992.01, P < 0.01 ). The detection rate of anemia in caries group (16.7%) was higher than that in caries free group (14.9%)( χ 2=7.98, P <0.01). Multivariate Logistic regression analysis showed that age ( OR =0.82) gender ( OR =1.27) urban area and rural ( OR =1.26) overweight ( OR =0.67) and obesity ( OR = 0.67 ) were all influencing factors of dental caries( P <0.01). Conclusion Dental caries is high among primary and middle school students in Henan Province, and dental caries affects their growth, development and nutritional status, and the prevention and control measures of dental caries among primary and middle school students should be strengthened.