Abstract: Objective To examine neglect status among rural primary school students in Chongqing municipality and Shaanxi province of western China and to provide a basis for health promotion in the students.Methods Using multistage stratified cluster sampling, a total of 1 874 primary school students at the age of 6-11 years were selected from rural areas of Chongqing municipality and Shaanxi province for the survey.Scales and evaluation methods in the Chinese Rural Children Neglect Survey were adopted in this Study.Results The overall neglect rate and overall neglect degree were 53.2% and 47.56±9.90 among the pupils.No significant difference was found in the prevalence of neglect between the boys and girls.The neglect rate and degree of all domains among the pupils aged 9-11 years were significantly higher than those of the pupils aged 6-8 years except for the degree of social and educational neglect.The neglect rates were 58.7% and 39.1% and the neglect degrees were 48.57±9.80 and 45.21±9.75 among the only child and non-only child pupils, with significant differences between the two groups.The neglect rate and degree of all domains among the pupils from the family of three generations under one roof and nuclear family were significantly lower than those among the pupils from single-parent family and remarried family except for social neglect rate.The neglect rate and degree among left-behind children were higher than those among non-left-behind children.The neglect rate and degree were significantly higher among the rural pupils in Chongqing municipality than those in Shaanxi province(66.4% vs.38.8% and 50.53±9.80 vs.44.87±9.20).Conclusion The neglect status in rural primary school students in Chongqing municipality and Shaanxi province is serious and more attentions should be paid to this situation.