Objective: To understand the current situation and demand school health education in five areas across China, and to provide theoretical support for further revision and improvement on school health education. Methods: Stratified multi stage cluster sampling was adopted. A total of 4 052 students were selected from five areas across China [Urumqi( n =1 295), Haikou City( n =448), Shijiazhuang City( n =788), Chengdu City( n =728), Suzhou City( n =793)]. Online questionnaire survey was conducted by questionnair star. Results: About 89.98% of the students used the use of uniform teaching materials, and 63.50% attended the health education classes once a week. The main sources of health knowledge, the use of uniform teaching materials, class schedule and the difference of teachers in different regions and periods were statistically significant ( χ 2=54.98, 40.97, 590.08, 1 061.12；50.70, 47.68 , 356.09, 193.30, P <0.05). The main source of health knowledge was from school/teachers(92.47%). Most health education teachers were classroom teachers(30.03%). Content of health education that students were interested in varied by gender and grade ( χ 2=20.91, 35.90, P <0.05), but not by area ( P >0.05). Demand for health knowledge of students varied by area and grade ( χ 2=177.29, 32.37, P <0.05). Conclusion The status quo of health education in schools is good. Further attention should be paid to cultivate high quality health education teachers and provide targeted health education activities according to students demand, and ultimately improving health literacy among students.