Abstract: Objective To explore the status of infectious disease epidemics or outbreaks and related factors in primary schools in Xi'an, so as to provide scientific basis for the development of school infectious disease prevention and control strategies. Methods A total of 92 primary schools were selected by probability proportionate to size sampling method. The information of infectious disease epidemics or outbreaks and related factors in these schools from 2013 to 2015 was investigated and related factors were analyzed by univariate and multivariate unconditional Logistic regression analysis. Results 31 of 92 schools have experienced 47 times of infectious disease epidemics or outbreaks from 2013 to 2015. All of the cases were respiratory infectious disease, of which 57.4% (27/47) was chickenpox epidemics. A total of 832 cases were reported, the average incidence rate was 8.7%, and the epidemics mainly occurred in winter and spring seasons. Multivariate Logistic regression analysis showed that high ventilation rate of classroom was a factor for the epidemics or outbreaks of infectious diseases in schools (OR=0.864, 95%CI:0.761-0.982,P=0.025), the comprehensive scores for prevention and control of infectious diseases were significantly higher in schools with infectious disease epidemics or outbreaks than those in schools without infectious disease epidemics or outbreaks (OR=1.277, 95%CI:1.013-1.610,P=0.039). Conclusions The main type of infectious diseases with epidemics or outbreaks in schools is respiratory infectious disease including chicken pox, mumps and influenza. Prevention and control should focus on these diseases. Increased classroom ventilation rates, and strengthened management of prevention and control can reduce the epidemics or outbreaks of infectious diseases in school.