Abstract: OBJECTIVE To evaluate the clinical efficacy and safety of azithromycin sequential treatment of mycoplasma pneumonia in children. METHODS Combination of computer and manual search was used. The relevant references on the effect of azithromycin sequential treatment of mycoplasma pneumonia in children which were published from 2005.1 to 2012.9 in China were explored, and Meta-analysis was taken on the qualified references. RESULTS Nine references including 737 patients met inclusion criteria. The systematic review showed that the total effective rate combined OR were 3.87, 95% CI was (2.23-6.71). The incidence of adverse drug reaction combined OR were 0.16, 95% CI was (0.11-0.24). CONCLSUSION The effect of azithromycin sequential treatment of mycoplasma pneumonia in children is better than that in control group. And the adverse reactions is less than the control group.