Objective: To explore the intra class transmission pattern of acute hemorrhagic conjunctivitis (AHC) among students, so as to provide a basis for formulating precise prevention and control strategies. Methods: The data of AHC students in 2023 was obtained from the teacher-student health information module of the "Xiamen i-Education" platform. Taking the onset date from January 1st to December 31st, 2023 as the search criteria, the epidemiological data of confirmed AHC cases among students in the whole city in 2023 was collected. And the Knox test method was employed to quantify cluster risk at the class level. Subgroup comparisons were conducted to examine differences in cluster risk between academic stages and gender combinations. Cross analysis was performed to investigate the interactive effects of two characteristics on cluster risk. Results: In 2023, 708 cases of AHC students were reported in Xiamen, among which 54 class clustered outbreaks were identified. These outbreaks accounted for 40.54% of total cases. Among them, the incidence of class clustered outbreaks with male first onset cases was higher than that with female first onset cases ( χ 2=4.55, P <0.05). The class cluster risk was at a relatively high level within the incubation period (0-2 d) after AHC onset ( RR =4.61-6.43, P <0.05). Subgroup analysis revealed that female-female case pairs had a higher class cluster risk ( RR = 4.81- 10.29) compared to other gender combinations ( P <0.05). Primary school case pairs showed a higher risk ( RR =4.60-6.77) than middle school case pairs ( RR =3.85-4.57) (both P <0.05). Cross analysis indicated that primary school and female-female combinations had a higher risk ( RR =4.70-11.24) than other combinations, while middle school and male-female combinations showed a positive interaction ( RR =3.68-6.68)(both P <0.05). Conclusions AHC infection among students is primarily transmitted within classes. Gender and educational stage are key demographic factors influencing class cluster transmission risks. Transmission risks should be assessed by analyzing population characteristics and contact patterns, and targeted interventions should be implemented.