Objective:To investigate the impact of prolonged screen time on myopia progression in children and evaluate the protective role of outdoor activities in mitigating its effects.Methods:A quantitative observational study was conducted with 85 children aged 6–14 years diagnosed with myopia. Baseline and follow-up assessments of spherical equivalent refractive error (SER) and axial length were performed over two years. Daily screen time, outdoor activity, and behavioral factors such as viewing habits were recorded using self-reported logs and questionnaires. Statistical analyses, including correlation and multiple regression, were used to assess the relationship between screen time, outdoor activity, and myopia progression.Results:Participants with high screen time (>4 hours/day) exhibited significantly greater myopia progression (-0.92 ± 0.18 D) and axial elongation (0.36 ± 0.08 mm) compared to those with low screen time (<2 hours/day; -0.35 ± 0.12 D, 0.16 ± 0.04 mm). Outdoor activity (>2 hours/day) was inversely correlated with myopia progression (-0.30 ± 0.10 D, 0.14 ± 0.03 mm) compared to low outdoor activity (<2 hours/day; -0.75 ± 0.20 D, 0.29 ± 0.07 mm). Regression analysis identified screen time (β = -0.42, p < 0.001), outdoor activity (β = 0.28, p = 0.01), and parental myopia (β = -0.35, p = 0.003) as significant predictors.Conclusion:Prolonged screen time significantly accelerates myopia progression in children, while outdoor activities provide a protective effect. Targeted interventions, including reduced screen time, improved viewing habits, and increased outdoor exposure, are essential to curb the rising prevalence of pediatric myopia.