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Objective To assess the prevalence rate of depressive symptoms in left-behind participants aged 7–17 years and to explore the associated socio-demographic and communication factors. Methods Participants were 4857 left-behind children and adolescents in Chongqing. They were screened for depressive symptoms using a 27-item Children׳s Depression Inventory (CDI) and social-demographic variables were evaluated with a structured scale. Uncorrected Pearson chi-square test and logistic regression were applied to analyzing the data. Results The total prevalence rate of depressive symptoms was 24.8%. Significant difference was found in the prevalence rate of depressive symptoms among groups of different income, grade, age, left-behind subtypes, and different frequency, ways and topics of parent-child communication. We found that the risk factors for depression were absence of parents, low frequency of parent-child communication, and communication by letter or about sensitive topics. The grade group 2–3 and age group 16–17 were at a higher risk of depression than all other grade and age subgroups. The protective factors for depression were high-income, high frequency of parent-child communication, communication by telephone or about such topic as learning experience, school life, and feelings. Limitations Self-report bias and cross-sectional nature of the sampling are major limitations of this study. Conclusions The prevalence rate of depressive symptoms among left-behind children and adolescents in Chongqing is much higher than previously reported prevalence in other regions of China. The risk and protective factors for depression among left-behind children and adolescents are worthy of public attention. [ABSTRACT FROM AUTHOR]