Background: This study used spectral-domain optical coherence tomography (SD-OCT) imaging to describe the distribution of macular ganglion cell complex (GCC) thickness and its association with ocular and systemic parameters in 7-year-old children in China. Methods: The study involved a school-based, cross-sectional analysis of the Anyang Childhood Eye Study (ACES) and included 2,505 first-grade students from urban areas in Anyang, Henan Province, Central China. All participants underwent systemic and ocular examinations. Both GCC and retinal nerve fiber layer (RNFL) thickness were measured using the iVue-100 OCT (Optovue, Fremont, CA, USA). Intraocular pressure (IOP) was recorded with noncontact tonometer (Huvitz, HNT-7000). Axial length (AL) was measured using optical biometry (Lenstar LS 900, Haag-Streit Diagnostics, Koniz, Switzerland). Results: The mean GCC thickness was 95.31 +/- 7.67 mu m. GCC thickness had negative associations with AL (r=-0.124, P<0.001), cup-to-disc (C-D) area ratio (r=-0.068, P=0.0033), horizontal C-D (H C-D) ratio (r=-0.048, P=0.0384), and vertical C-D (V C-D) ratio (r=-0.074, P=0.0013). Positive correlations were found with spherical equivalent (SE) (r=0.080, P=0.0001), RNFL thickness (r=0.363, P<0.001), height (r=0.059, P=0.0036), fovea parameters, disc area (r=0.078, P=0.0007), rim area (r=0.115, P<0.001), rim volume (r=0.119, P<0.001), and optic nerve head volume (r=0.097, P<0.001). GCC thickness had no significant association with IOP, age, sex, or weight, waist, or head circumference. Conclusions: This study provides normative GCC data for 7-year-old healthy children in China. The findings support an association between GCC and AL, SE, RNFL, height, and C-D ratio in children.