Clinical relevance Large-scale data on the association between body stature with biometry parameters and refraction in young adults facilitates an understanding of myopia development. Taller persons have eyes with more negative refractions, longer axial lengths, deeper anterior chambers, flatter corneas, and higher axial length-corneal radius ratio. Background To determine the relationship between body stature with ocular biometry and refraction in young adults. Methods This was a cross-sectional university-based study of 16- to 26-year-old students in China. Cycloplegic refraction and corneal curvature were measured using an autorefractor. Ocular parameters, including axial length, anterior chamber depth and lens thickness, were measured using a Lenstar LS900. Data on height and weight were acquired from an annual standardised physical examination and body mass index was calculated. Results Of 7,971 participants examined in the school clinics, 5,657 (71.0 per cent) were available in the analysis. After adjusting for age, gender, parental myopia, time outdoors, near work and weight, each centimetre of height increase was associated with more negative refraction of -0.023 D, a 0.032 mm increase in axial length, a 0.003 mm increase in anterior chamber depth, a 0.008 mm increase in corneal curvature, and a 0.001 increase in axial length-corneal radius ratio. With regard to weight, a 1 kg heavier person was more likely to have less negative refraction of 0.011 D, a 0.001 mm increase in anterior chamber depth and a 0.002 mm increase in corneal curvature. A similar pattern of significant associations was also found in body mass index. Conclusion Taller, young adults tended to have longer eyes, deeper anterior chambers, flatter corneas, higher axial length-corneal radius ratio, and more negative refraction, adjusted for potential confounders. In contrast, heavier and higher body mass index persons are more hyperopic. The differences in stature may partially explain the variation in refraction and ocular biometric parameters.