Objective To understand the prevalence of screening myopia among primary and secondary school students in Zhoukou City,and to provide evidence for the formulation of prevention and control measures. Methods The subjects were selected from primary and secondary schools in Zhoukou City according to the principle of multi-stage stratified cluster random sampling,distant vision and refractive examination were performed. Results The prevalence of screening myopia was 52.39% in 16 539 primary and secondary school students from 2019 to 2021.The prevalence of screening myopia in female students (57.46%) was higher than that in male students (47.00%) (χ²=181.228,P<0.001).The screening myopia rate of primary and secondary school students from 2019 to 2021 were 49.87% ,54.68% and 52.47%,respectively(χ²=20.787,P <0.001).There was no significant difference(χ²=0.390,P=0.532)in the prevalence of screening myopia between urban students (56.25%) and suburban students (48.86%).There was a significant difference in the prevalence of screening myopia among different grades (χ²=4 729.900,P<0.001),and the prevalence increased with the grade (χ²_trend=3874.431,P <0.001),and the largest increase was found in grade 4(63.54%).The prevalence of screening myopia was 28.18% in primary school,73.79% in junior high school and 80.97% in senior high school.The detection rate of screening myopia increased with the increase of school stage(χ²_trend=3 569.766,P<0.001).The proportion of low myopia decreased with the increase of the school stage,and the proportion of moderate myopia and high myopia increased with the increase of the school stage. Conclusion The prevalence of screening myopia among primary and secondary school students in Zhoukou City is high.Targeted prevention and control measures should be taken to improve the myopia situation of primary and secondary school students.