Objective: To understand tuberculosis screening for newly enrolled students in Hunan Province and to provide reference for scholl based tuberculosis (TB) prevention and control. Methods: During 2018 to 2020, TB screening was carried out for newly enrolled students in Hunan Province, and the screening results were statistically analyzed by descriptive analysis and χ 2 test. Results: In 2018-2020, the average incidence rate of TB among students in Hunan Province was 20.90/100 000, with a decreasing trend by year ( χ 2 trend =89.45, P <0.01), the screening rate of TB in schools was 87.30%, and the screening rate for newly enrolled students was 86.81%, with downward trend by year ( χ 2 trend =2 843.34, 83 443.77, P <0.01). The proportion of suspicious symptoms, close contact, and active pulmonary TB patients among students were 0.53%, 0.21%, and 1.73/10 000, respectively, with decreasing trends by year( χ 2 trend =8 624.05, 2 215.48, 99.14, P <0.01). The proportion of strong positive PPD/ IGRA positive, changes in imaging examination and culturepositive of mycobacterium tuberculosis were 1.52%,0.20% and 12.40%, with increasing trends by year ( χ 2 trend =529.18, 147.65, 25.89, P <0.01). There were statistically significant differences in the proportion of suspicious symptoms, close contact, strong positive PPD/positive IGRA, changes in imaging examination and the proportion of patients with tuberculosis in the regional classification and school classification ( χ 2=529.18, 8 823.13, 705.63, 2 068.03, 1 299.00, 4 318.73 , 33.12, 2 329.07, 35.80, 1 781.65, P <0.01). There was no statistically significant difference in the proportion of culture positive of mycobacterium tuberculosis in the regional classification and school classification ( P >0.05). Conclusion The screening rate of newly enrolled student showed an upward trend, and the incidence rate of tuberculosis among students showed downward trend. Newly enrolled students among fresh students in high school have the highest PPD positive/IGRA positive rate and the proportion of pulmonary tuberculosis in the student population. It is necessary to increase the screening among fresh students in high school. In areas with conditions, tuberculosis screening of senior two students can be considered.