OBJECTIVE： To compare economical efficiency of 4 therapeutic regimens for pediatric perianal abscess. METHODS： By retrospective study method， 85 children were divided into group A （18 cases）， B （10 cases）， C （14 cases） and D （43 cases） according to different therapeutic regimens. They were given amoxicillin-flucloxacillin， flucloxacillin， cefathiamidine and cefamandole 100 mg/（kg·d） intravenously for 5-7 d， respectively. Clinical efficacies and the occurrence of ADR were compared among 4 groups. The economical efficiency of 4 therapeutic regimens were analyzed by the method of cost-effectiveness analysis. RESULTS： For group A， B， C and D， the cure rates were 77.78％， 80.00％， 57.14％ and 90.70％， that of group C was significantly lower than those of other 3 groups， with statistical significance （P＜0.05）. No significant ADR were found in 4 groups. The costs were 3 600.86， 2 913.92， 3 416.19 and 2 981.97 yuan， and the cost-effectiveness ratios were 46.30， 36.42， 59.79 and 32.88. The incremental cost-effectiveness ratios of group A， C and D to group B were －309.43， －21.97 and 6.36. The results of cost-effectiveness analysis were supported by sensitivity analysis. CONCLUSIONS： For pediatric perianal abscess， cefamandole shows the best cost-effectiveness； but the therapeutic duration and total cost of flucloxacillin therapeutic regimen is shorter and lower. Therapeutic regimen should be selected according to children’s condition.