Objective To analyze the clin. features, therapeutic methods and prognosis of necrotizing pneumonia (NP) in children. Methods We retrospectively collected and analyzed the data of 41 children diagnosed with necrotizing pneumonia hospitalized in Maternal and Child Health Hospital of Hubei Province from Jan. 1, 2017 to Feb. 1, 2021. Results 1) Forty-none pediatric patients with NP were enrolled, 20 cases were boys, 21 cases were girls; the average age of the patients were 2.5 years (0.5∼12.5 years). The average febrile time were 3∼20 (10.51±4.16) days. 2) Complications: There were 19 cases of dyspnea (17.07%), 7 cases of ventilater-assisted ventilation (43.43%), 23 cases of pleural effusion (56.10%), 19 cases of myocardial damage (46.43%), 17 cases of impaired liver function (41.46%), 9 cases of toxic encephalopathy (19.51%), 2 cases of Stevens-johnson syndrome (4.88%). 3) Etiol.: 27 cases of mycoplasma pneumoniae infection, 6 cases of bacterial infection, 1 case of aspergillus infection, 7 cases of unknown pathogen. 4) The median peak value of WBC in peripheral blood was 17.27×109/L, the ratio of neutrophil was (68.27±15.03)%, the median peak value of CRP was 64.06 mg/L, and 15 cases (36.57%) had a peak value of CRP greater than 100 mg/L. The median peak value of PCT was 0.6 ng/L, and that of LDH was 426 U/L. The median of D2 polymers was 4.3 μg/mL. 5) Chest imaging examination: the course of the disease was (17.78±6.23) days after cavitation and cystic cavity appeared in the area of consolidation, most of which were absorbed by imaging within 1 yr. 6) Bronchoscopy showed hyperemia, edema and purulence of trachea and bronchus in 40 cases, plastic bronchitis in 2 cases, erosion in 7 cases, necrosis of bronchial mucosa in 24 cases, bronchial stenosis in 29 cases, bronchiectasis in 3 cases, bronchial subsegment occlusion in 4 cases, and new organism in 1 case. 7) After treatment, all 41 children had a good prognosis, 20 cases (48.78%) experienced temperature drop and symptom relief after glucocorticoid treatment, and 20 cases (48.78%) experienced clin. relief after gamma globulin treatment, and the hospital stay was 10∼46 (21.27±9.11) days. Conclusion Mycoplasma pneumoniae is an important pathogenic bacteria causing pediatric necrotizing pneumonia with long fever time, length of hospital stay, and imaging absorption time. The bronchoscopic findings are severe and varied, accompanied by complications such as pleural effusion, corticosteroids and gamma globulin application can relieve clin. symptom, shorten the course of the disease, and has mostly good prognosis.