Objective To understand the trend and influencing factors of vitamin A status among students from the pilot area of the “Nutrition Improvement Program for Compulsory Education Students in Rural Areas”( Shorten as “Program”) in Hainan Province from 2014 to 2017. Methods From 2014 to 2017, a total of 2 603 students were selected from Qiongzhong county in Hainan Province through stratified cluster random sampling method. The serum retinol and other indicators were detected and questionnaire survey were carried out. Results In 4 years, the average serum retinol concentration of students was (333.4±81.9)-(370.9±88.1) ng/mL, with an overall variation trend of decline and then increase (P<0.05 ) ; The subclinical vitamin A deficiency (SVAD) rate of students was 18.0% to 31.5%, which increased first and then decreased (P<0.05) ; and the vitamin A deficiency (VAD) rate was 0.8% to 2.0%, without significant change in 4 years (P>0.05). From 2014 to 2017, The serum retinol concentration of junior high school students was higher than that of primary school students (P<0.05), except for 2015, there was no statistically significant difference between different genders (P>0.05) ; and the SVAD rate of junior high school students was lower than that of primary school students (P<0.05). The minority nationality (OR=2.290) and anemia (OR=2.373) were risk factors for SVAD or VAD, the junior middle school students (OR=0.235) and daily outdoor activity time≥30 min (OR=0.554) were protective factors. Conclusion The nutritional status of vitamin A among students in the region had been improved, but the SVAD was still a striking problem, the minority nationality and pupils were at higher risk, and improving anemia and increasing outdoor activity might help reduce the risk of SVAD or VAD in students. To understand the trend and influencing factors of vitamin A status among students from the pilot area of the “Nutrition Improvement Program for Compulsory Education Students in Rural Areas” (Shorten as “Program”) in Hainan Province from 2014 to 2017. Methods From 2014 to 2017, a total of 2 603 students were selected from Qiongzhong county in Hainan Province through stratified cluster random sampling method. The serum retinol and other indicators were detected and questionnaire survey were carried out. Results In 4 years, the average serum retinol concentration of students was (333.4±81.9) ～ (370.9±88.1) ng/mL, with an overall variation trend of decline and then increase(P<0.05); The subclinical vitamin A deficiency(SVAD) rate of students was 18.0% to 31.5%, which increased first and then decreased (P<0.05); and the vitamin A deficiency(VAD) rate was 0.8% to 2.0%, without significant change in 4 years(P>0.05). From 2014 to 2017, The serum retinol concentration of junior high school students was higher than that of primary school students (P<0.05), except for 2015, there was no statistically significant difference between different genders (P>0.05); and the SVAD rate of junior high school students was lower than that of primary school students (P<0.05). The minority nationality (OR=2.290) and anemia (OR=2.373) were risk factors for SVAD or VAD, the junior middle school students (OR=0.235) and daily outdoor activity time≥30 min (OR=0.554) were protective factors. Conclusion The nutritional status of vitamin A among students in the region had been improved, but the SVAD was still a striking problem, the minority nationality and pupils were at higher risk, and improve anemia and increasing outdoor activity might help reduce the risk of SVAD or VAD in students.