This study aims to examine the relationship between high birth weight (HBW) and blood pressure and assess whether HBW leads to increased hypertension during childhood and adolescence. All the participants aged 6-18 years with HBW were selected from a cross-sectional study from seven provinces in China. Nine thousand nine hundred and sixty-two children were randomly sampled with matched data. Basic information of students was collected with a standardized student and guardian questionnaire. High blood pressure was defined according to sex-, age- and height-specific references. Multi-variance logistic regression was used to estimate the odds ratio (OR) of high blood pressure and HBW after adjustment for confounding factors. The overall mean of systolic BP and diastolic BP in HBW group were significantly higher than normal group in both genders and urban/rural area. Corresponding overall prevalence of high BP, elevated SBP and elevated DBP in HBW group were also higher than normal group in both genders, respectively (boys: 19.41% vs 16.16%; 10.12% vs 8.16%; 14.86% vs 12.71%; girls: 14.95% vs 12.66%; 8.19% vs 6.56%; 11.13% vs 9.86%). In addition, birth weight was positively associated with high BP, elevated SBP and elevated DBP in children and adolescents of both sexes (boys: OR 1.25, 1.27, 1.20; girls: OR 1.21, 1.27, 1.15). However, the positive association was attenuated and even reversed after adjustment for potential confounding variables. In this study, HBW may lead to higher childhood blood pressure, but no association between HBW and childhood hypertension was observed.