Abstract: Objective To understand the current situation and cognitive level of accidental injury of left-behind primary school students in poor areas and to provide theoretical basis for the formulation of comprehensive intervention measures for accidental injury of left-behind children.Methods The method of cluster random sampling was used. A total of 1000 students from 4 primary schools in Z poverty-stricken county of Gansu province were investigated for accidental injuries. Result The risk factors of accidental injury of leftbehind children were 6-8 years old (OR = 2. 175),Boys (OR = 2. 469) and their parents with primary school education or below (OR = 2. 222). Introverted personality (OR = 0. 246) and only child (OR = 0. 591) were the protective factors of accidental injury of left-behind children. There were significant differences in the cognitive levels of drowning,burn and scald,cut (0. 050) and drug misuse (0. 028) among left-behind pupils with different personalities. There were statistically significant differences in the cognitive level of left-behind primary school students with different personalities in regard to drowning (P = 0. 006),burns (P = 0. 007) and cut (P = 0. 050) and drug misuse (P = 0. 028) among left-behind primary school students with different personalities.Conclusion Effective comprehensive intervention measures should be formulated according to the current situation and the cognitive level of left-behind children. The primary school students,their parents and teachers should be actively involved in the education of accident prevention and emergency treatment,with emphasis on strengthening the comprehensive intervention of extraverted primary school students.