〔Abstract〕 Objective To investigate the effect of adjuvant treatment of Xiaoer Feike granules on cough degree and traditional Chinese medicine (TCM) syndrome score of children with cough after pneumonia. Methods A total of 64 children with cough after pneumonia admitted to Luoyang Central Hospital Affiliated to Zhengzhou University from January 2020 to February 2023 were randomly divided into a control group and an observation group, with 32 cases in each group. The control group was treated with azithromycin, and the observation group was treated with Xiaoer Feike granules on the basis of the control group. Both groups were treated for 2 weeks. The total effective rate, cough severity score (CET), TCM syndrome score, CD3⁺ , CD4⁺ , CD8⁺ levels and incidence of adverse reactions were compared between the two groups. Results The total effective rate in the observation group was higher than that in the control group, the difference was statistically significant (P < 0.05). The CET scores in the observation group after 1 week and 2 weeks of treatment were lower than those in the control group, the differences were statistically significant (P < 0.05). After treatment, the TCM syndrome score of the observation group was lower than that of the control group, and the difference was statistically significant (P < 0.05). After treatment, the levels of CD3⁺ and CD4⁺ in the observation group were higher than those in the control group, and the level of CD8⁺ was lower than that in the control group, with statistical significances (P < 0.05). There was no significant difference in the occurrence of adverse reactions between the two groups (P > 0.05). Conclusion Xiaoer Feike granules assisted treatment of cough after pneumonia can alleviate the cough symptoms of children, TCM symptoms, and promote the recovery of immune function in children.