Objective To study the relationship between writing strokes and myopic anisometropia in primary school-aged children.Methods It was a cross-sectional study.The refractive data of 100 primary school-aged children who held a pencil in the correct position was collected in the outpatient department of ophthalmology.In addition,the refractive data of another 100 primary school-aged children who held a pencil in an abnormal position was collected.All the screened children who tested for amblyopia,strabismus or astigmatism higher than 1.0 D were excluded from the study.The cycloplegic refractive status of all the screened children was checked and recorded.The difference between the two groups' refractive status was calculated and compared using a Wilcoxon rank sum test.Results Data analysis showed that the difference between the average degree of anisometropia between the two groups was statistically significant.The group with the abnormal writing hand position had a higher average degree of anisometropia than the group with the right writing strokes (Z=-10.33,P＜0.01).And more right eyes had a higher degree of myopia than left eyes.Conclusion An abnormal writing hand position can be an important cause of school-aged children developing myopic anisometropia with right eyes often having a higher degree of myopia than left eyes.Further study is needed on this topic for clarification.