Abstract: Objective: This study aims to explore the role of physical exercise in preventing and controlling myopia in school-age children, as well as to analyze the relationship between changes in physical parameters and ocular biometrics parameters, and to provide theoretical basis support and practical guidance for formulating scientific and effective myopia prevention and control measures. Methods: 178 third-grade primary school students were divided into four groups based on their visual status: the normal vision control group (n=45), the normal vision intervention group (n=45), the myopia control group (n=44), and the myopia intervention group (n=44). Both the normal vision intervention group and the myopia intervention group underwent an exercise protocol for one academic year, with 3 sessions per week, each lasting 40 minutes. The intervention focused on moderate-intensity aerobic training targeting the improvement of the ability to focus on distant and near objects and the ability of visual tracking. Before and after the intervention, all participants were tested for ocular biological parameters including spherical equivalent refraction (SER), axial length (AL), corneal curvature radius (CR), anterior chamber depth (ACD), and body morphology data including height, weight, and body mass index (BMI). The collected data were analyzed using paired-sample t-tests, independent-sample t-tests, and multivariate linear regression analysis. Results: 1) After one academic year, the SER level of the normal vision control group was significantly lower than before the intervention (P＜0.01), and AL was significantly higher than before the intervention (P＜0.01), AL/CR and ACD were also significantly higher than before the intervention (P＜0.01). In the normal vision intervention group, AL was significantly higher than before the intervention (P＜0.01), while SER showed no significant change. Compared to the normal vision control group, normal vision intervention group had a smaller decrease in SER (−0.50±0.73) D vs (−0.08±0.55) D, P＜0.01. The incidence of new myopia in the normal vision intervention group was 35.1%, significantly lower than 48.6% in the normal vision control group (P＜0.05). 2) After one academic year, compared to those before the intervention, the SER level in the myopia control group was significantly lower than before the intervention (P＜0.01), and AL was significantly higher than before the intervention (P＜0.01). AL/CR and ACD were also significantly higher than before the intervention (P＜0.05). In the myopia intervention group, AL was significantly higher than before the intervention (P＜0.01), while SER showed no significant change. In comparison to the myopia control group, the myopia intervention group had a smaller decrease in SER (−0.70±0.66) D vs (−0.22±0.97) D, P＜0.05. 3) Multivariate linear regression analysis revealed a significant positive relationship between changes in height and AL in the myopia control group (β=0.052, P＜0.01), indicating that for every 10 cm increase in height, AL increased by 0.5 mm. No significant regression relationship was observed between the changes in body morphology indicators and ocular biological parameter changes in the other groups. Conclusion: Regardless of whether the children were non-myopic or myopic, regular participation in moderate-intensity physical exercise focusing on visual tracking can significantly slow down the decline in their SER, effectively preventing the onset and progression of myopia. For children with myopic, physical exercise may suppress the abnormal growth of AL and attenuate the correlation between height and the concurrent growth of AL.