Introduction In Peru, there are few studies which show that they might be a difference between school children in rural areas and the ones from non-rural areas, this is necessary because it has been shown that the place of residence is an influential exogenous factor in the development of low visual acuity. Likewise, the influence of environment on the development of visual errors and low visual acuity has been demonstrated. Methodology Case-control study between child population of an urban and a rural area (Piura and Joras); prior informed consent of their parents. The primary variable was the visual acuity, qualified with the principles of Snellen (sensitivity 85%, specificity 96%) 20/0 was considered as optimal and normal visual acuity was considered to 20/25. Values below were low visual acuity. Results 1,094 were surveyed. 50.0% (488) were female, and the median age was 9 years (interquartile range: 7-10 years). 22.6% (221) of the children had low visual acuity. In bivariate analysis, the age of children (p = .001), the degree coursing (p <.001) and city of residence (p = .005) were associated with low visual acuity of children. The multivariate analysis found that non-rural children had 1.55 (95% CI: 1.14 to 2.11, p-value = .005) more chances of having low visual acuity, adjusted for sex, age and degree academic growth of children. Conclusions It is concluded that children living non-rural residences have more low visual acuity in the northern Peru. / Revisión por pares