ObjectivesThis study aimed to investigate the epidemiological characteristics and preliminarily explore possible risk factors of physical activity-related injury (PARI) occurrences among Chinese university students via a multicentre mixed survey.DesignCross-sectional study.ParticipantsA total of 4758 undergraduates graded 1–3 in nine universities in three Chinese cities were enrolled via cluster random sampling and completed the self-administered online questionnaires during March and April 2017.Main outcome measuresPARI in the past 12 months.ResultsOf the 4758 participants, 1081 sustained PARI in the past 12 months, with an overall PARI incidence rate of 22.7% (27.3% (367/1343) in males and 20.9%(714/3415) in females). Around one-quarter of the injured (26.4%) suffered from PARI over at least three episodes. More than half of the injured subjects experienced physical activity (PA) absenteeism and sought medical attention. All PA indicators were significantly and positively associated with PARI, with a frequency of sports and leisure-time vigorous-intensity PA (VPA) participation being the strongest (adjusted OR: 1.079, 95% CI: 1.018 to 1.144). Moreover, males (OR=1.199), Shantou students (OR=4.239), year 1 students (OR=1.287), university and other sports team members (OR=1.717–2.360) and those with insufficient sleep time (OR=1.262–1.333) were also at a higher risk of PARI.ConclusionsPARI is prevalent among university students in China. The frequency of sports and leisure-time VPA participation was most strongly associated with PARI among all PA indicators. These data can inform future programmes for injury intervention among university students. Safety issues should also be emphasised when promoting PA among the public to reduce PARI.