The invention relates to the technical field of power distribution, and discloses a medium-voltage switch cabinet and a power distribution system. The medium-voltage switch cabinet comprises a switch cabinet, a bus chamber, a switch chamber and a cable chamber which are mutually independent are arranged in the switch cabinet, an environment factor detection module is arranged in at least one chamber, and the environment factor detection module is used for detecting whether indoor environment factors are abnormal or not; and the medium-voltage switch cabinet also comprises an alarm module, and the alarm module is connected with the environment factor detection module and is used for giving an alarm when the environment factors are abnormal. According to the medium-voltage switch cabinet, through cooperation of the environmental factor detection module and the alarm module, an alarm can be given when an early cause of an electrical fault exists in a room, so that an operator can find the fault cause very early, maintain the fault cause in time and prevent the fault cause from being evolved into the electrical fault, and the probability of the electrical fault can be reduced. Meanwhile, the medium-voltage switch cabinet can reduce the risks of equipment damage, power failure, production halt, disordered life order and the like, so that the continuity and reliability of power supply can be improved.