Objective To investigate the impact factors of the willingness of organ donation among middle school students and effective measures to raise public awareness and willingness towards organ donation. Methods Questionnaires including demographic data，donation willingness，knowledge and attitude，death attitude，altruism behavior and family discussion about organ donation were delivered to 228 middle school students in Guangzhou. The correlation between the variables and the willingness of organ donation was analyzed with Spearman rank correlation， and the multivariate analysis was conducted by multiple linear regression model. Results The scores of willingness of self organ donation，willingness of relatives' organ donation，knowledge and attitude toward organ donation among middle school students were 2.29±0.88，3.46±1.11，2.30±1.61，110.11±24.68，respectively. The score on the neutral-acceptance dimension of death attitude was the highest 19.28±4.44. The score of altruism behavior was2.98±0.82. The score of willingness to communication scale was 4.28±1.54. The students with history of blood donation and plan to regularly donate blood had higher willingness to donate organs（P ＝ 0.004）. Willingness of organ donation was positively correlated with attitude towards organ donation，altruism behavior，willingness to communicate and willingness of relatives' organ donation（P ＜ 0.05）. Approach acceptance dimension of death attitude was negatively relevant with willingness of organ donation（P ＜ 0.05）. Conclusion The willingness of organ donation among middle school students were on the average level and its predictors were attitude toward organ donation and altruism behavior. Measurement such as reinforcement of propagenda education，incentive of altruism behavior and improvement of compensation and legislation systems may contribute to the enhancement of the public willingness to donate organ.