Background Data: Low back pain (LBP) is a very common health problem worldwide and a major cause of disability affecting students' well-being. However, the prevalence and risk factors of LBP among preparatory school students have not been widely investigated in Egypt. Various risk factors such as obesity, family history, stress, and exercise have been described in the literature. Purpose: To evaluate the prevalence and risk factors of LBP among students at preparatory schools in the Fayoum governorate. Study Design: A descriptive cross-sectional study. Patients and Methods: The study was conducted among 384 Egyptian preparatory school students in Fayoum governorate aged 12–16 years. A self-complete questionnaire was used to assess LBP prevalence, physical leisure activities, and other school-related factors. Results: The prevalence of LBP was 25% (n = 96) of all examined students (n = 384), in which 53.1% were females and 46.9% were males. Among the LBP sufferers, 55.2% of students had a positive family history of LBP, and the difference was statistically significant compared to those who did not have LBP. Of the total 96 students, 10.4% were exposed to trauma, 6.3% were exposed to infection such as chest infection or urinary tract infection, and 76% (n = 73) of patients suffered from acute LBP. Conclusion: Our study showed a high prevalence of LBP, which was 25% of all examined. Both physical and psychosocial factors constitute a risk for LBP. Knowledge about LBP in school children and adolescents could be important in assessing and treating such a health problem. (2021ESJ240)