Objective To investigate the prevalence and lifestyle factors of elevated blood p ressure among primary and secondary school students in Wuhan, aiming to provide insights for scientific prevention and control strategies .Methods Using a stratified random cluster sampling method, students aged 7-18 from 91 schools across 13 administrative districts in Wuhan were selected. for physical examinations and questionnaires. Univariate analyses and multivariate logistic regression analyses were conducted to assess the prevalence and associated factors of elevated blood pressure. Results The prevalence of elevated blood pressure among 20,466 students aged 7-18 was 21.05%; with rates of 22.26% for males and 19.70% for females. Multivariate logistic regression indicated that students in urban areas, junior or senior high school, overweight or obese individuals, and those not consuming breakfast daily or not engaging in daily moderate to high-intensity exercise had higher odds ratios of 1.739(1.620-1.867),1.779(1.597-1.981),1.375(1.215-1.556),1.628(1.490-1.778),2.827(2.597-3.077),1.099(1.007-1.201) and 1.288(1.135-1.461), respectively) for elevated blood pressure. Conversely, students with more than three physical education classes per week exhibited a lower risk(OR=0.817, 95%CI=0.696-0.959). Conclusion The prevalence of elevated blood pressure among primary and secondary school students in Wuhan is relatively high and is associated with urbanization, educational level, and lifestyle factors (such as overweight or obese, breakfast habits and exercise frequency). It is recommended to emphasize blood pressure screening among students and implement preventive measures to reduce the risk of elevated blood pressure.