Objective: The aim was to investigate the relationships among extreme sports participation, sensation seeking, and negative risky behaviors (smoking, drinking alcohol, and gambling) for middle-school students.Methods: Using a convenience sampling procedure, all students from a middle school in a district of Chongqing were selected to participate in the survey, which included questions on their extreme sports participation rate, and smoking, drinking alcohol, and gambling behavior.Results: A sample of 2,987 middle-school students participated in this study. The results showed that the proportions of students participating in extreme sports, smoking, drinking alcohol, and gambling were 19.9, 4.8, 18.4, and 3.0%, respectively. There were significant differences between different genders, schools, place of residence, smoking, drinking, gambling, and sensation seeking of the participation rate of students of extreme sports, the rate of boys, junior middle-school students, urban students, smokers, alcohol drinkers, gamblers, and high-sensation-seeking students were relatively higher than that of girls, senior middle-school students, rural students, no-smokers, no-alcohol drinkers, no-gamblers, and low-sensation-seeking students. Alcohol drinking, gambling, and sensation seeking were associated with extreme sports participation, and the students who drank alcohol, who gambled, and who were high sensation seeking were more likely to participate in extreme sports than those who did not drink alcohol, who did not gamble, and who were low sensation seeking.Conclusion: Middle schools should integrate extreme sports education into physical education and risky-behavior education, strengthen relevant knowledge and safety training, and guide students to meet their sensation-seeking needs through participation in extreme sports instead of risky behaviors.