Objective: To study the relationship between intraocular pressure (IOP) and myopic refractive error in children. Methods: This was a cross-sectional study. A total of 2 126 grade 6 primary school students from the Anyang Childhood Eye Study, with an average age of 12.2±0.4 years, were included. The study was conducted in Anyang, Henan Province, from March to July 2017. Cycloplegic refraction was measured using an autorefractor, and spherical equivalent (SE) was calculated. IOP was examined by non-contact tonometry. Ocular biometry, including axial length, central corneal thickness, anterior chamber depth, and lens thickness, was measured using Lenstar LS900. IOP levels were divided into low (IOP<14 mmHg), moderate (14 mmHg≤IOP≤16 mmHg), and high (IOP>16 mmHg) using population tertiles. Emmetropia was def ined as SE between -0.5 and +0.5 D, hyperopia as greater than +0.5 D, and myopia as SE less than -0.5 D. Low myopia was defined as -0.5 D≤SE<-3.0 D, moderate myopia as -6.0 D≤SE<-3.0 D, and high myopia as SE<-6.0 D. Only the data for the right eye was used. The relationship between IOP and refractive errors was analyzed using an independent samples t-test, analysis of variance (ANOVA) with a post hoc Scheffé test and linear regression analysis. Results: The IOP of all subjects was 15.06±3.40 mmHg, and the SE was -1.36±2.08 D. The myopic refractive error in the low, moderate and high IOP level groups gradually increased and the difference was statistically significant (F=3.863, P=0.021). The SE (-1.22± 1.96 D) in the low IOP level group was significantly lower than the SE (-1.52±2.22 D) in the high IOP level group (P=0.021). The difference in IOP among different categories of refractive errors was statistically significant (F=2.695, P=0.029). The lowest IOP was 14.77±3.31 mmHg in the hyperopia group, and the highest IOP was 16.32±3.55 mmHg in the high myopia group. The IOP difference between the two groups was 1.55 mmHg (P=0.047). Using IOP as the dependent variable, the linear regression model after adjusting for other covariates showed that a higher IOP was significantly associated with a higher degree of myopia (β=-0.168, P=0.013). Conclusions: A higher intraocular pressure is significantly associated with a higher degree of myopia. Intraocular pressure may play a role in the development of myopia in children, but the causality still needs further study.