To examine the level of knowledge and skills related to prevention of child sexual abuse CSA in a sample of Chinese preschoolers in Beijing and to explore the associations between children's scores on the knowledge and skills and their parents' reports on the knowledge and communication with children about CSA prevention. One hundred and thirty-six preschoolers were interviewed by researchers using the Chinese versions of Personal Safety Questionnaire and the What If Situation Test, and one parent of each child was invited to complete an anonymous questionnaire regarding parental knowledge and parent-child communication about CSA prevention. Less than half children knew that strangers were not the only perpetrators and only 16% thought that children should report secret touching. In 3 inappropriate touching requests, less than 30% of the children were aware of using verbal response to definitely refuse the inappropriate touching and less than 20% of the children were aware of definitely removing themselves from the abusive situations. Parent-child communication about CSA and parental educational level were the significant factors for children's self-protection skills. Preschool children lack CSA prevention knowledge and related self-protection skills. Culturally relevant primary CSA prevention programs in China need to be developed and parental education should be a part of CSA prevention. Parents need to be informed about CSA knowledge concepts and need to be encouraged to communicate with their children about sexual abuse prevention.