OBJECTIVE： To evaluate the efficacy and safety of Azithromycin for injection in the treatment of mycoplasma pneumonia in children， and to provide evidence-based reference for clinical use. METHODS： Retrieved from CNKI， Wanfang database， CBM， PubMed， Embase and Cochrane Library，randomized controlled trials （RCTs） about Azithromycin for injection （trial group） versus other positive drugs （control group） in the treatment of mycoplasma pneumonia in children were collected. Meta-analysis was conducted by using Rev Man 5.3 statistical software after data extraction and quality evaluation with Cochrane system evaluator manual 5.2.0. RESULTS： A total of 20 RCTs were included finally， involving 1 793 children with mycoplasma pneumonia. Control groups were treated with erythromycin. Results of Meta-analysis showed that the total response rate [RR＝1.13， 95％CI （1.06，1.20），P＜0.001]， defervescence time [RR＝－1.03， 95％CI（－1.43， －0.64）， P＜0.001]，cough time [MD＝       －2.34， 95％CI（－3.13，－1.55）， P＜0.001]， time of lung rale disappearance [MD＝－2.54， 95％CI（－4.37， －0.70），P＝0.007]， time of chest shadow disappearance [MD＝－1.76， 95％CI（－3.43， －0.09）， P＝0.04]， hospitalization day [MD＝－2.72， 95％CI（－3.50， －1.94）， P＜0.001] in trail group were better than control group， with statistical significance. The incidence of overall ADR [RR＝0.39，95％CI（0.31，0.49），P＜0.001]， gastrointestinal ADR [RR＝0.36，95％CI（0.28，0.47），P＜0.001]， liver toxicity [RR＝0.55，95％CI（0.34，0.89），P＝0.01]，infusion reaction [RR＝0.31，95％CI（0.20，0.48），P＜0.001]， rash [RR＝0.34，95％CI（0.20，0.59），P＜0.001]， abdominal pain [RR＝0.21，95％CI（0.09，0.49），P＜0.001] in trail group were significantly lower than control group， with statistical significance. CONCLUSIONS： Azithromycin for injection is effective and safe in the treatment of mycoplasma pneumonia in children.