Objective: To investigate the screening status of latent tuberculosis infection (LTBI) among primary and middle school students in Taizhou City, Zhejiang Province, so as to provide the evidence for optimizing campus tuberculosis prevention and control strategies. Methods: Data including affiliated administrative regions, school types, and student numbers from 2023 to 2025 were collected through schools. Relevant data on LTBI screening results among fourth- and fifth-grade primary school students, along with newly enrolled students in junior high schools, senior high schools, and secondary vocational schools in Taizhou City during the same period were collected through Centers for Disease Control and Prevention at county (city, district) level. The LTBI screening rate and detection rate were calculated, and descriptive analysis was conducted to compare screening and examination rates across different school types and regions. Results: A total of 601 537 primary and secondary school students were enrolled from 2023 to 2025, among whom 547 074 received LTBI screening, with an overall screening rate of 90.95%. The screening rate increased from 82.51% in 2023 to 95.73% in 2025, showing an upward trend (P<0.05). A total of 17 219 LTBI cases were identified, with an overall detection rate of 3.15%. The detection rate rose from 2.26% in 2023 to 4.40% in 2025, also with an increasing trend (P<0.05). Statistically significant differences in LTBI screening rate and detection rate were observed among students from different school types (both P<0.05). Primary schools had a relatively low screening rate of 86.48%, while secondary vocational schools had a higher LTBI detection rate of 4.47%. There were also significant differences in the two rates across different counties (cities, districts) (both P<0.05). Xianju County and Wenling City presented lower screening rates at 80.89% and 78.48% respectively. Sanmen County and Tiantai County had higher detection rates of 5.35% and 6.11% respectively. Conclusions Both LTBI screening rate and detection rate among primary and secondary school students in Taizhou City increased from 2023 to 2025. The screening work needs to be further strengthened among primary school students, as well as in Xianju County and Wenling City. Students in secondary vocational schools are key populations for prevention and control, and Sanmen County and Tiantai County are key areas.