[Abstract] To explore the effects of family environment influences, especially parent-child companionship and parents' video screen cognitive attitudes, on preschool children's screen exposure in Changzhou, health surveillance data of 5812 children aged 3 to 6 years old in Xinbei District of Changzhou City were collected for statistical analysis. The results revealed that a significant proportion of preschool children in Changzhou, 1861 (32.0%) to be exact, were exposed to screens for an average of at least one hour per day. Multivariate Logistic regression analysis showed that after controlling for age, gender, family income, and family structure, the number of electronic devices used by children, parents' supportive attitudes toward children's use of electronic devices, the duration of parent-child companionship, the use of electronic devices during parent-child interactions, and indifference to children were all risk factors for excessive screen exposure in preschool children(OR=1.08, 2.30, 1.04, 1.21, 1.26, all P<0.01). Family environmental factors had a significant effect on screen exposure in preschool children. Thus, to effectively reduce excessive screen exposure in preschool children, it is crucial for families to prioritize parent-child companionship and for parents to maintain positive cognitive attitudes towards their children's screen time.