Abstract: Objective To examine current status and influence factors of sexual and reproductive knowledge and sexual behavior among rural school adolescents and to provide references for improving sexual- and reproductive-related health among the rural adolescents.Methods A self-designed questionnaire survey was conducted among 548 rural pupils of grade 5 and 6 and rural junior high school students of grade 1 and 2 selected with cluster random sampling in Xingyi municipality of Guizhou province from March to April 2015.Univariate and multivariate logistic regression analyses were used to explore influence factors of sexual and reproductive knowledge and sexual behavior.Results Of the rural school adolescents surveyed,54.2% had general sexual and reproductive health knowledge (answering >80% of the related questions correctly).The results of multivariate logistic regression showed that male gender (adjusted odds ratioaOR=1.454,95% confidence interval95%CI=1.027-2.058),regular communication with parents (OR=1.460,95%CI=1.003-2.125),regular communication with teachers (OR=1.608,95%CI=1.129-2.289),and having sexual and reproductive health courses (OR=2.035,95%CI=1.418-2.919) were statistically associated with having general sexual and reproductive health knowledge.Among the adolescents,5.8% reported the experience of sexual behavior.The results of multivariate logistic regression revealed that regular communication with parents (OR=0.267,95%CI=0.128-0.558) and having sexual and reproductive health courses (OR=0.447,95%CI=0.216-0.925) were statistically associated reversely with having sexual behavior.Conclusion Rural school adolescents in Xingyi municipality are lack of knowledge about sexual and reproductive health and related education among the adolescents needs to be promoted in the schools and families.