Abstract: Objective To understand awareness and associated factors of infectious disease prevention in Xi'an primary school students.Methods A multistage stratified cluster sampling method was used to investigate 4 454 students in 93 primary schools from 14 counties of Xi'an.Multiple linear regression analysis was conducted in analyzing associated factors of infectious disease prevention.Results The awareness rate of infectious diseases prevention among primary school students in Xi'an was 48.5%.No significant difference was found between boys and girls(P=0.164).The awareness rate was highest among urban students (54.5%),followed by suburban students(47.3%),and lowest among rural students(38.9%) (P<0.05).The formation rate of health behavior was 68.9%,with girls higher than that of boys(P<0.05) and with urban area the highest,followed by suburbs and rural areas(P<0.05).The top three access to knowledge are classroom teaching or lecture(56.3%),family or friend(49.2%) and TV or radio(35.7%),and the top three requirements for intervention methods were classroom teaching or lecture(69.9%),TV or radio (40.2%) and propaganda column or blackboard(37.5%).Multiple linear regression analysis showed that students with lower parental education level and from rural areas had fewer awareness on infectious disease prevention(t =-16.990,7.516,P<0.01).Among them,boys and those who reported having infectious diseases within a year had the least awareness(t =-12.162,9.020,8.083,4.862,P<0.01).Conclusion The awareness on infectious disease prevention among primary school students in Xi'an is not sufficient and greatly needed.School-based health education should focus on effective classroom teaching,while pay close attention to students from rural areas and whose parents with a lower education background.