The study evaluated the distribution of relative peripheral refraction (RPR) and its relationship to ocular biometry in 309 Chinese children aged 4 to 14 years, divided into three groups: hyperopia, emmetropia, and myopia. IOLMaster 700 biometry and multispectral refractive topography were used to measure RPR, described by refractive difference values (RDV) in different peripheral regions such as TRDV, RDV15, RDV15–30, RDV30–45, RDV45–53, temporal (RDV-T), nasal (RDV-N), superior and inferior. In emmetropic and myopic children, RPR became more positive with increasing distance from the foveal pit, while in hyperopic children, relative hyperopic defocus decreased at RDV45–53. Above 30° eccentricity, there were significant differences between groups, with emmetropic and myopic children having higher RPR than hyperopic children. Spherical equivalent was negatively correlated with RDV-T (β = −0.31, p < 0.01) and TRDV (β = −0.26, p < 0.01), in myopes the correlation extended to more areas with increasing myopia. The strongest relationship with RDV45–53 was the ratio of axial length to corneal radius of curvature (AL/R, β = 0.48, p < 0.01). In emmetropic and myopic children, the RPR indicates a relative peripheral hyperopic shift with greater eccentricity, on the contrary, it decreases above 30° in hyperopic children.