Abstract: Objective To examine the status quo and influencing factors of health literacy among middle school students in Guiyang city.Methods Using multistage stratified cluster sampling,we conducted a survey on health literacy among 3 295 junior and senior high school students in two districts of Guiyang municipality during May 2015 with modified Health Literacy Questionnaire for Chinese Residents-2014 designed by China Health Education Center.SPSS 20.0 was used in data analyses.Results Of the students,only 5.5% showed adequate health literacy.The highest ratio of adequate health literacy was for basic health skills (30.0%) and the lowest was for basic health knowledge and attitude (4.6%) among the students.For the 6 health literacy related items,the highest correct answer ratio was for safety and first aid (47.8%),while the lowest was for chronic disease prevention and control (10.4%).The results of univariate χ² test showed that residential region,with local registered residence,being only one child,whether having health lectures in school,parental education level,self-rated academic achievement,and the grade were significant impact factors of health literacy (P<0.01 for all); multivariate logistic analysis revealed that the health literacy of the students was influenced by residential region,parental education level,self-rated academic achievement,whether having health lectures in school,and grade.Conclusion The health literacy is at a low level and the level is mainly influenced by parental education level,academic achievement,study grade,and whether having health related lectures in school among middle school students in Guiyang city.