OBJECTIVE： To investigate therapy efficacy of large-dose of methylprednisolone plus therapy for acute myelitis，and it effects on nerve function recovery，pyramidal tract conduction function and sensory disturbance. METHODS： A total of 116 patients with acute myelitis were randomly divided into observation group and control group， with 58 cases in each group. Both group received conventional treatment. Control group was additionally given Dexamethasone sodium phosphate injection 0.4 mg/（kg·d） intravenously， once a day； 7 d later， they were given Methylprednisolone tablet 60 mg， orally，qd，gradually decreasing to 5 mg/d. Observation group was given Methylprednisolone sodium succinate injection 1 000 mg intravenously， once a day； 7 d later，they were given Methylprednisolone tablet 60 mg， orally，qd， gradually decreasing to 5 mg/d. The treatment course in eaeh group was 1 month. The nerve function recovery time， pyramidal tract conduction function， sensory disturbance scores， clinical efficacy and ADR were compared between 2 groups. RESULTS： After treatment， the response rate of observation group was significantly higher than that of control group （93.10％ vs. 79.31％）； the time of muscle strength improvement≥grade 2， walking down the ground， urination and defecation function recovery in observation group were all significantly shorter than control group， with statistical significance （P＜0.05）. Before treatment， there was no statistical significance in lower limb cone conduction latency， amplitude of pyramidal tract conduction， scores of sensation， sense of pain and touch between 2 groups. After treatment， lower limb cone conduction latency of 2 groups were significantly lower than before， and the observation group was significantly lower than the control group， the amplitude of pyramidal tract conduction， scores of sensation， sense of pain and touch in 2 groups were significantly higher than before， and the observation group was significantly higher than the control group， with statistical significance （P＜0.05）. There was no significant difference in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Based on conventional treatment，large-dose of methylprednisolone plus therapy shows good efficacy in the treatment of acute myelitis，which can helps to improve pyramidal tract conduction function of patients with acute myelitis， ease sensory disturbance， promote the nerve functional recovery with good safety.