Objective: To investigate the current status of health literacy regarding children’s vision protection among preschool teachers and to provide a basis for targeted training. Methods: A convenience sampling method was employed to conduct a questionnaire survey among 1,442 preschool teachers in Xiangyang City from April to June 2024. The questionnaire covered five dimensions: knowledge, beliefs, behaviors, skills, and policies. Item response rates were used to identify literacy gaps. Results: The overall vision protection literacy of preschool teachers exhibited characteristics of “strong beliefs but weak knowledge and skills”. The item response rates for each dimension, from highest to lowest, were: beliefs (92.7%), policies (81.9%), behaviors (74.8%), knowledge (67.5%), and skills (58.3%). The core gaps were concentrated in the “knowledge” and “skills” dimensions, with significant deficiencies particularly in the understanding of the concept of “hyperopia reserve” (awareness rate: 27.6%), skills in guiding behaviors for myopia prevention and control (mastery rate: < 50%), and the ability to interpret vision screening results (complete mastery rate: 35.0%). Conclusion: Currently, there are significant structural deficiencies in the health literacy of kindergarten teachers regarding children’s vision protection. In the future, greater emphasis should be placed on practical skills training, particularly in enhancing their practical abilities in areas such as “hyperopia reserve” cognition and interpretation of vision screening results.