Abstract: Objective: To investigate the special motor skills level of Shanghai adolescents and explore its relationship with physical activity and physical health. Methods: The research data came from the “National Physical Health Standards for Students(revised in 2014)” monitoring program of Shanghai primary and middle school students in 2019, and the sample was drawn according to stratified and random cluster sampling method. There are 83 730 students from junior high school to senior high school among the data, and a total of 55 851 students with one guardian completed the questionnaire survey(completion rate is 66.7%). After data screening, a total of 54 576 students' data were included in the final analysis, which include 27 387 boys(50.2%), 34 306 junior middle school students(62.9%), and 16 395 urban adolescents(30.0%). The subjects' mastery of special motor skills and the level of Moderate-to-Vigorous Physical Activity(MVPA) were measured through questionnaires. Results: Overall, there were significant gender, grade and region differences in BMI and mastery of special motor skills(P<0.05). %N-SKILL(the proportion of subjects without special motor skills) and % Fit(the good and excellent rate of physical health standards) of boys were lower than those of girls(13.3 vs 14.0%, P<0.05; 19.1 vs 34.8%, P<0.05), but the boys' MVPA-D(the number of days reached the recommended 60 minutes of MVPA daily) and %MVPA7(the proportion of subjects reached the recommended 60 minutes of MVPA daily) were both greater than those of girls(4(3,6) vs 4(2,5) days, P<0.001; 10.6 vs 5.9%, P<0.001). The % N-SKILL of junior high school students was lower than that of senior high school students(P<0.001), but their MVPA-D, %MVPA7 and %Fit were significantly higher than those of senior high school students(P<0.001). For the urban adolescents, their %N-SKILL, MVPA-D and %MVPA7were lower than those of suburban adolescents(P<0.001), but the % Fit was better than that of suburban adolescents(P<0.001).The results of binary logistic regression showed that the MVPA-D was positively correlated with those with excellent physical health standards(Ptrend<0.001) after adjusting for covariate age, sex, grade and region, and the odd ratio(OR) was 1.146(95% CI: 1.133,1.158). After adjusting for covariate age, gender, grade, region and MVPA-D, there was a positive correlation between the mastery of special motor skills and the excellent physical health standard(Ptrend<0.001), and the OR was 1.499(95% CI: 1.453, 1.546).Conclusion: Most of the teenagers in Shanghai have high level special motor skills, but a few teenagers have no sports skills, and the differences in are observed in gender, learning period and region. The level of MVPA-D and the mastery of special motor skills are positively correlated with the excellent grade of physical health standard and are independent of each other. It is suggested that to optimize the evaluation method of special motor skills gradually, improve the physical health level of adolescents following the characteristics of their grades and gender, and promote the formation of lifelong sports exercise habits are effective ways to improve adolescents' physical health level.