To provide evidence for the effective prevention of suicide in middle school students by exploring the relationship between adverse childhood experiences (ACE) and suicide risk in them. Methods: A total of 4807 middle school students from 12 schools in a central province were selected. The revised Childhood Adversity Questionnaire (ACE-IQ) was used to assess their adverse childhood experiences. Based on the Chinese version of the Mini International Neuropsychiatric Interview (MINI) suicide risk subscale, the project team added questions assessing the suicide risk within 12 months and throughout development. The revised suicide risk assessment questionnaire was used to evaluate the suicide risk of middle school students. Independent sample t-test and one-way ANOVA were used to compare the differences in suicide risk scores in students with different demographic characteristics. Pearson product difference correlation analysis was used to investigate the correlation between four dimensions of ACE and suicide risk. Multivariate Logistic regression modeling was used to analyze the correlation between four dimensions of ACE and suicide risk. Results: In the middle school students, 830 were at risk of suicide within one month, and the detection rate of suicide risk was 17.27%. In them, 431 (9.0%) had low suicide risk, 161 (3.3%) had moderate suicide risk, and 239 (5.0%) had high suicide risk. There was a significant positive correlation between the risk of suicide and the scores of the four dimensions of ACE (P<0.01), in which physical abuse and neglect and violence outside the family were highly correlated with suicide risk (r=0.236, 0.243). After controlling for age, only child status, gender, and family economic status, binary Logistic regression showed that the OR values of child abuse and neglect, family dysfunction, family absence, and violence outside the family were 2.193, 1.589, 1.408, and 2.524, respectively (all P<0.05). Con? clusion: This study suggests that the detection rate of suicide ideation in middle school students is high. ACE is a risk factor for suicide risk in middle school students, and the suicide risk is higher in middle school students who experienced violence outside the family during childhood.