〔Abstract〕 Objective To evaluate the effectiveness of azithromycin in children with mycoplasma pneumonia. Methods 72 cases of mycoplasma pneumonia admitted to Hanshou County People's Hospital from February 2018 to April 2020 were selected and divided into control group and observation group by drawing lots method, with 36 cases in each group. The observation group chose the conventional treatment combined with azithromycin treatment, and the control group chose the conventional treatment combined with erythromycin treatment. The effective co-occurrence of the treatment intervention, the total time spent on chest X-ray examination results returning to normal, the total elapsed time of absence of rale at lung, the total consumption time of fever subsided, and the total consumption time of cough performance missing in the two groups were analyzed and compared. The results of spirometry before and after treatment were observed. Results The total effective rate of the observation group was 94.44%, which was higher than 77.78% of the control group, the difference was statistically significant (P ＜ 0.05); The recovery time of all clinical indicators of the observation group was shorter than that of the control group (P < 0.05). There was no statistically significant difference in the lung capacity between the two groups before treatment (P > 0.05). After treatment, the vital capacity of the two groups of children increased to varying degrees, and the vital capacity of the observation group was better than that of the control group, the difference was statistically significant (P < 0.05). Conclusion The treatment of azithromycin in children with mycoplasma pneumonia can get better therapeutic effect, which can help relieve their symptoms and signs as soon as possible, and promote the improvement of their vital capacity.