Objective To investigate the screening and prevalence of tuberculosis among freshmen in different schools in Baoding City, and provide reference for tuberculosis control in schools. Methods Screening data of tuberculosis and tuberculin test (PPD) of freshmen from 156 schools in different regions of Baoding City from September 2021 to March 2022 were collected. PPD screening results of students from different regions and different school stages were analyzed and compared. Results A total of 68 177 freshmen from 156 schools were investigated for suspected symptoms and close contact history of pulmonary tuberculosis. PPD screening was conducted on 63 939 students. 13 821 students were PPD positive, with a positive rate of 21.62%. 3 083 students were strongly positive, with a strong positive rate of 4.82%. 15 cases of tuberculosis were found, and the reported incidence was 23.46/100 000. PPD positive rate and strong positive rate as well as incidence of tuberculosis in students in different school stages presented statistically significant differences (all P < 0.01). Positive rate and strong positive rate in students in different school stages showed upward trends (all P < 0.01). PPD positive rate and strong positive rate of students from schools in plain and mountainous areas presented statistically significant differences ([22.28% vs 17.89%]; [4.85% vs 3.62%], both P < 0.01). PPD positive rate and strong positive rate between students from boarding junior school and non-boarding junior school were significantly different, respectively ([23.94% vs 21.60%]; [5.07% vs 3.56%], both P < 0.01). Conclusion It is necessary to strengthen tuberculosis screening and health education for freshmen, especially those from boarding schools in plain areas, screening latent Mycobacterium tuberculosis infection as early as possible, take corresponding measures to prevent and control the spread of tuberculosis, and reduce the risk of tuberculosis.