Objective: To investigate refractive errors and associated factors among Tujia teenagers in Youyang County of Chongqing. Methods: Urban and rural Tujia students (n=973) from four middle and high schools in Youyang County of Chongqing were selected by random cluster sampling. Visual acuity was checked by auto refractometry, and retinoscopy was performed after pupil dilation by 1% cyclopentanone.Factors related to visual acuity, parental refractive status and including outdoor activities, were recorded.Statistical analyses were performed by Pearson chi-square test and Pearson and Spearman correlation analyses. Results: The prevalence of myopia [spherical equivalent (SE) ≤-0.50 diopter (D)], hyperopia(SE≥+0.50 D), and astigmatism (≤-0.50 D) was 66.3% (645 cases), 17.5% (170 cases), and 15.1% (147 cases) respectively. Twenty-five students (2.6%) had high myopia. Males had a lower prevalence of myopia (59.8%) than females (72.5%) ( χ 2 =17.53, P < 0.001). Urban students (77.9%) had a higher prevalence than rural students (51.6%) ( χ 2 =74.12, P < 0.001). The prevalence of myopia increased with age ( χ 2 =84.70, P < 0.001), while the prevalence of hyperopia decreased ( χ 2 =78.30, P < 0.001). In myopes the incidence of myopia in both parents or only one parent was greater compared to non-myopes ( χ 2 =10.85, P=0.001; χ 2 =56.01, P < 0.001 respectively). Outdoor activities were correlated with a reduction in the incidence of myopia (r 2 =0.781, P < 0.001). Conclusions:Male teenagers had a lower prevalence of myopia than females in Youyang County, Chongqing, China. Urban teenagers had a higher prevalence of myopia than rural students. Myopia was related to parental myopia and outdoor activities.