Objective: To investigate mental health status and associated factors among middle school students from single parent families in urban Lishui, and to provide reference for mental health education for adolescents from single parent families. Methods: In the urban area of Lishui City, a total of 160 middle school students from single parent families in four middle schools were selected by stratified random sampling, among 160 middle school students from two parent families were selected matched for class, gender, age and family background, and Mental Health Diagnostic Test Scale (MHT) was used for testing. Results: In terms of allergy tendency, physical symptoms, phobic tendency and total anxiety detection, middle school students from single parent families were higher than those from two parent families, and the differences were statistically significant ( χ 2=5.70, 5.34, 6.84, 4.30, P <0.05). Among the 160 middle school students from single parent families, the detection rate of girls in learning anxiety, anxiety towards others, self blame tendency, allergic tendency, physical symptoms, terror tendency, impulsive tendency and total anxiety were higher than that of boys, and the differences were statistically significant. ( χ 2=12.26, 4.61, 7.34, 14.96, 20.53, 10.05, 16.19 , 9.39, P <0.05). Multivariate Logistic regression analysis showed that gender was positively associated with mental health of middle school students in singleparent families ( OR=4.25, 95%CI=1.87-7.02, P <0.05). Conclusion There are a higher prevalence of psychological problems among middle school students from single parent families in Lishui city, especially among girls, which warrents further psychosocial services including mental health education.