Abstract: Objective  To analyze the epidemiological characteristics of tuberculosis among students in Guangxi and their cross-regional medical consultations for a reference in implementing effective prevention and control measures. Methods  The incidence of tuberculosis reported among the whole population and students in Guangxi were obtained from 2020 to 2024 through the Chinese Disease Prevention and Control Information System, and analyzed for the trends in tuberculosis incidence among students, epidemiological characteristics, and the proportion of patients seeking medical treatment outside their home region. Results  From 2020 to 2024, a total of 7 683 cases of tuberculosis among students were reported in Guangxi, with an average annual incidence rate of 13.60 per 100 000. The annual incidence rate showed a fluctuating downward trend, decreasing from 16.78 per 100 000 in 2020 to 11.94 per 100 000 in 2024. By temporal distribution, two epidemic peaks, namely September-October (20.53%, 1 577/7 683) and December-January of the following year (22.05%, 1 694/7 683) were observed. In terms of demographic distribution, there were 3 909 male cases (50.88%) and 3 774 female cases (49.12%). Cases aged 16-18 years occupied the largest proportion of incidence (46.53%, 3 575/7 683). The city with the highest number of reported cases and the highest reported incidence rate was Nanning (1 052 cases) and Baise (26.43 per 100 000), respectively. Among students studying outside Guangxi, the majority chose to return to their places of origin for medical treatment (79.33%, 353/445), and those who were studying within Guangxi, 39.42% (2 814/7 139) underwent medical treatment in local area, 35.19% (2 512/7 139) sought cross-district treatment within the city, and 25.40% (1 813/7 139) sought treatment in other cities. Conclusion  The overall incidence of tuberculosis among students in Guangxi exhibits a fluctuating downward trend, with an uneven regional distribution of cases and a notable trend of cross-regional medical visits. These findings suggest that it is necessary to strengthen routine monitoring and active screening of the cases, particularly the targeted measures shall be prioritized for high school students aged 16-18 years. In addition, prevention and control measures should be optimized according to regional differences in epidemic, and health management for students who move frequently should be enhanced to effectively curb the spread of tuberculosis on school campuses.