〔Abstract〕 Objective To investigate the application of modified pediatric early warning score (MPEWS) in pediatric emergency pre-examination triage. Methods A total of 3000 children treated in Shaoguan Maternal and Child Health Care Hospital from January 2020 to April 2021 were selected. 1500 children treated with routine pre-examination triage care were selected as the control group, and 1500 children treated with MPEWS combined with graded care were selected as the observation group. The time of pre-examination triage, triage accuracy, incidence of medical disputes and family satisfaction were compared between the two groups. Results The time of pre-examination triage and waiting time in the observation group were shorter than those in the control group, and the differences were statistically significant (P < 0.05). The triage accuracy of the observation group was higher than that of the control group, and the incidence of medical correction was lower than that of the control group, the differences were statistically significant (P < 0.05). The satisfaction scores of pre-examination triage, waiting time and medical service efficiency in the observation group were higher than those in the control group, with statistical significances (P < 0.05). Conclusion The application of improved early warning score in pediatric emergency triage can accurately assess the severity of children's disease, improve the efficiency of triage, and enable children to receive timely treatment and care