Astigmatism is a refractive error due to irregular shape of cornea or lens. This may disrupts life since 80% of daily information is received through vision. Astigmatism commonly occurs in school-aged children. The genetic and lifestyle factors are estimated to play a role in astigmatism. The objective of the study was to determine the relationship between genetic and lifestyle factors with astigmatism in children. It was an analytic-observational cross-sectional study. Each eye of 76 children who went to JIH Hospital and RSU PKU Muhammadiyah Gamping Yogyakarta Eye Clinic, from January to December 2016 was examined and they filled out questionnaires. Consecutive sampling method was undertaken and data were analyzed using multiple linear regression test. The result showed that there was a relationship between genetic and lifestyle factors with astigmatism in children. Genetic factor was highly associated with astigmatism in children (p= 0,003, 95% CI for B= 0,52-1,18) compared to lifestyle factors, such as the habit of using gadget (p= 0,015, 95% CI for B= 0,50-1,01), reading (p= 0,204, 95% CI for B= -0,49- 0,46), and watching television (p= 0.211, 95% CI for B= -0,55-0,25) more than two hours a day.