Objective  To estimate the occurrence of sexual behavior among college students in mainland China and to provide references for sex education in colleges.

  Methods  We searched studies on the occurrence of sexual behavior among college students in China published from January 2010 through November 2016 via China National Knowledge Infrastructure (CNKI), Wanfang and PubMed databases, then conducted a meta-analysis on the data collected with Stata12.0.

  Results  A total of 66 studies (61 in Chinese and 5 in English), involving 476 262 participants, were included. Among the participants, the pooled occurrence rate of sexual behavior was 15.1 % (95 % confidence interval95 % CI: 13.9 % – 16.4 %, P < 0.001); the occurrence rate was significantly higher in the male participants than in the female participants (21.1 % vs. 10.6 %, χ² = 6167.307; P < 0.001) and significantly higher in the participants of eastern China than in those of central and western China (16.4 % vs. 14.8 % and 14.8 %, both P < 0.001); the occurrence of sexual behavior gradually increased with grade (χ² = 271.355, P < 0.001), with the rates of 9.5 % in the freshmen, 12.8 % in the sophomores, 18.2 % in the juniors, and 23.9 % in the seniors, respectively. The participants studying in colleges during the period of 2010 – 2015 reported a higher occurrence of sexual behavior than those having their studies during 2005 – 2009 (17.4 % vs. 14.6 %). There was no statistically significant publication bias for the included studies based on Begg’s test (Z = 0.26, P = 0.799).

  Conclusion  The occurrence of sexual behavior was high among college students in China, suggesting that there is an urgent need forspecific compulsory educations on sexual behavior among the students according to their epidemiological characteristics in sexual activities.