OBJECTIVE： To observe the efficacy and safety of azithromycin sequential therapy in the treatment of mycoplasma pneumonia in children. METHODS： 67 children with mycoplasma pneumonia were randomly divided into control group （34 cases） and observation group （33 cases）. All children received conventional treatment， such as fever， cough， supplemented by nutrition support； based on it， control group received 10 mg/kg Azithromycin for injection， adding into 5％ Glucose injection by intravenous drip in 200 ml， once a day； observation group received azithromycin （the same dosage with control group） after intravenous drip 5 d， switched to 10 mg/（kg·d） Azithromycin dry suspension， orally， then stopped 4 d after continuous 3 d. The treatment course was 7-10 d. Clinical efficacy， disappearance time of fever， cough and lung rales， and lung indexes before and after treatment， and the incidence of adverse reactions in 2 groups were observed. RESULTS： There were no significant differences in the total effective rate， disappearance time of fever， cough and lung rales in 2 groups （P＞0.05）. After treatment， the lung function indexes were significantly higher than before， the differences were statistically significant （P＜0.01）， but there was no significant difference between 2 groups （P＞0.05）. The incidence of adverse reactions in observation group was significantly lower than control group， the difference was statistically significant （P＜0.05）. CONCLUSIONS： Based on conventional treatment， azithromycin sequential therapy shows similar efficacy to without sequential therapy in the treatment of mycoplasma pneumonia in children， but with better safety.