Objective: To investigate knowledge, attitude and behavior related to tuberculosis prevention among primary and elementary school students in Heilongjiang province, and to provide evidence for school-based tuberculosis prevention and control. Methods: A cross-sectional survey method was used to conduct a questionnaire survey among 3 033 middle and elementary school students in 10 counties (districts) of Heilongjiang province, including knowledge, attitudes and behaviors related to tuberculosis prevention and treatment. Results: In the survey, 61.5% of the students understand the core information of tuberculosis. The core knowledge awareness rate was higher in primary school students (64.8%) than in middle school students(58.1%)(χ2=85.41，P<0.05). Primary and middle school students indicated that the attitude-taking rate of concerns about the tuberculosis patients was 47.5%. Primary school students had more general attitude than middle school students towards willingness to participate in publicity activities compared with primary school students(χ2=39.26，P<0.05). About 85% of students reported personal hygiene habits. The results of multiple linear regression analysis showed that tuberculosis-related knowledge was mainly associated with factors including urban and rural, parental education, health education courses in school(P<0.05). Conclusion There is a gap in tuberculosis-related knowledge among primary and middle school students between Heilongjiang province and national level. There’s a need for the improvement of tuberculosis control programs to inform a better understanding and social dissemination of TB information.