Open AccessSchool dropout has become a serious problem in many places around the world. However, before students actually dropout from school, they normally exhibit some symptoms of disengagement from the social life and emotional involvement of school. Thus, hidden school disengagement or avoiding school psychologically may be an early stage of school dropout. This article examines the phenomenon of hidden school disengagement among students aged 12-16 in China. 14,563 students in 11 provinces and 2 administrative regions participated in a Youth Health Behaviors Survey conducted in 2010. Based on the Index of Hidden Disengagement, 2,854 students (19.6%) were identified as having multiple symptoms of disengagement. Further analysis suggested that students who were identified as hidden disengaged students had a significantly higher ratio of being involved in health-related risk behaviors, suffered from psychosomatic symptoms, and had a pessimistic outlook of their health and their lives. Personal and contextual factors, such as students with one or more siblings in the family, non-intact families, low family economic background, migrant families, left-over children, schools located in rural areas, and non-model schools, all contributed to a higher prevalence of hidden school disengagement.