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This study aims to analyze the high-order thinking skills through a scientific approach on respiration system. The population was all students of eleventh grade in SMA Negeri 4 Medan totaling 440 people. Samples were taken by purposive sampling technique, namely as many as 6 classes with a total of 210 students. This research was a descriptive study so that the data was analyzed to make a systematic, factual, and accurate description of students high-order thinking skills. The instrument for collecting data used cognitive tests at the C4-C6 level. The results showed that: (1) the students high-order thinking skills in SMA Negeri 4 Medan on respiration system at the C4 level (application) was 90.5 (very good). The percentage of graduation is 63.8% or 134 students, and (2) the students average cognitive skills per indicator on respiration system was 68.9. Based on the results of this study, it can be concluded that the students high-order thinking skills in SMA Negeri 4 Medan was in a good category.