Abstract: OBJECTIVE To explore the risk factors of iatrogenic opioid withdrawal(IOW) in critically ill pediatric patients, and to provide evidences for clinical prevention of IOW. METHODS The 111 pediatric patients hospitalized in intensive care unit from October 2016 to October 2018 who received continuous opioid for ≥ 5 d were selected. The datas of dosages, complications and weaning plan of opioid use, the age and gender of these subjects were collected by retrospective analysis. The withdrawal items were scored according to the Sophia observation withdrawal symptoms scale(SOS), and the risk factors of IOW were analyzed by univariate methods. RESULTS The incidence of IOW was 45.05%, with 50 patients scores of SOS ≥ 4 and 61 patients scores ≤ 3. There were no significant differences in age, gender, complications, maintenance dose, duration of therapy, intermittent infusion, and weaning plan between the two groups. While the occurrence of withdrawal reaction of fentanyl was significantly correlated with its cumulative dose in the two groups(P=0.1). CONCLUSION Cumulative dose and duration of therapy are the most predictive risk factors of IOW. While other risk factors failed to evaluate the occurrence of IOW.