Abstract： Objective To investigate the effects of ketogenic diet therapy on sleep quality and emotion recognition ability of children with autism spectrum disorder(ASD).Methods Eighty-two children with ASD treated in Julu County Hospital from August 2021 to August 2022 were analyzed retrospectively.According to different treatment plans,the patients were assigned in a 1∶1 ratio to routine rehabilitation training+ordinary diet(control group)and ASD routine rehabilitation training+ketogenic diet(treatment group)for 6 months.The Aberrant Behavior Checklist(ABC)score,Children's Sleep Habits Questionnaire(CSHQ)score and emotion recognition ability were compared between groups.Results After treatment,the sensory ability,communication ability,motor ability and language ability of the treatment group were significantly better than those of the control group(P＜0.05).After treatment,poor sleeping habits,sleep anxiety,irregular sleep duration,daytime sleepiness,night waking,prolonged sleep latency and total CSHQ score in the treatment group were significantly lower than those of the control group(P＜0.05).After treatment,the ability of emotion recognition of upright,inverted,and blurred faces in the treatment group were significantly higher than those of the control group(P＜0.05).Conclusion Ketogenic diet therapy can reduce the degree of ASD disease,improve the sleep quality and enhance the ability of emotion recognition,which is worthy of clinical promotion.