Background This study aimed at determining urogenital schistosomiasis (UGS) prevalence, intensity, knowledge and risk factors in school-aged children (SAC) in the new endemic focus of Tiko, Cameroon. Methods A cross-sectional study including 389 SAC of both sexes aged 5–15 years was carried out between April and June 2018. A structured questionnaire was used to collect demographic data, clinical and predisposing factors. Urine sample collected was used to detect Schistosoma haematobium eggs by filtration technique and microhaematuria by Heme dipstick COMBI 11. Logistic regression model was used to determine risk factors of UGS. Results The overall prevalence of UGS was 37.0% (CI 32.4–41.9) and 32.6% (CI 28.2–37.5) were positive by egg excretion while 24.4% (CI 20.4–28.9) by haematuria. S. haematobium egg excretion and haematuria were significantly higher in males (P = 0.016; P = 0.049) and children 12–15 years old (P = 0.009; P = 0.002), respectively. The mean number of eggs per 10 mL of urine was 77.6 (10.2) and ranged from 2 to 400. The proportion of light intensity of infection was higher (67.7%, CI 59.2–75.2) with no significant differences by sex, age and residence. However, the older children were more heavily infected when compared to the younger children, who had more of light infection. Overall, the mean knowledge score 1.42 (CI 1.32–1.51) on a scale of 6, was poor and the proportion of good knowledge of the disease (23.14%, CI 19.2–27.6) was low. Stream water contact (AOR = 4.94; P = 0.001) was the only significant risk factor identified. Conclusion Urogenital schistosomiasis is of public health concern among SAC in Tiko, Cameroon. Most participants have poor knowledge about the disease, hence education on vector-borne diseases and the avoidance of stream water contact should be implemented.