Abstract: Objective To examine self-esteem status and its related factors among middle school students in Zhengzhou city of Henan province and to explore applicable measures to promote self-esteem of the students.Methods A total of 4 891 urban and rural students in 8 middle schools in Zhengzhou city were recruited with stratified random cluster sampling.All the participants were investigated with Self-Esteem Scale,Child Trauma Questionnarire-Short Form (CTQ-SF),Social Support Questionnaire,and Multidimensionnal Life Events Rating Questionnaire (MLERQ).Results The proportions of the students with high and low self-esteem score were 84.8% and 15.2%,respectively.Compared to those of the girls,rural students,junior high school students,and non-only children,higher average self-esteem scores were observed among the boys (28.95±4.998 vs.28.37±4.728),urban students (28.80±4.997 vs.28.50±4.773),senior high school students (28.82±4.884 vs.28.52±4.854),and only children (29.18±5.053 vs.28.48±4.797).The self-esteem score was positively correlated with familial economic condition and study achievement of the students.The students with lower self-esteem score had significantly higher scores for childhood abuse (42.10±11.753 vs.38.66±12.362)and MLERQ (37.56±24.704 vs.22.90±21.064),and lower score for social support (60.18±15.146 vs.70.59±13.884) cmpared to the students with higher self-esteem score (all P<0.001).Multivariate linear regression analyses showed that higher subjective support,less stress life events,lower emotional neglect,better study achievement,male,better family economic condition,less stress events in physical development,high school students,being an only child,and lower emotional abuse had positive influences on self-esteem level among the students.Conclusion There are some self-esteem related problems among middle school students in Zhengzhou city.Gender,grade,whether being an only child,study achievement,familial economic situation,childhood abuse experience,social support,and stressful life events have influences on self-esteem level of the students.