Abstract： Objective:The clinical data of pediatric patients with mycoplasma pneumoniae pneumonia (MPP) admitted to the Department of Respiratory and Critical Care Medicine of our hospital were retrospectively analyzed, to explore the early identification of severe mycoplasma pneumoniae pneumonia (SMPP) requiring bronchoscopic treatment.Methods:158 cases of mild and severe MPP were recruited in our hospital from November 2023 to December 2023 during the outbreak of Mycoplasma infection, divided into the control group with non-bronchoscopic treatment 74 cases and the observation group with bronchoscopic treatment 84 cases. Then, the gender, age, highest body temperature, white blood cells, neutrophils, hypersensitive C-reactive protein, chest CT features, disease course, hospitalization time, and hospitalization costs of the two groups of patients were analyzed.Results:In the observation group, the age of children was mainly 7-9 years old (63.10%), and the condition is mainly severe (71.43%), with a significant difference compared to the control group (P<0.05). The highest body temperature, admission hypersensitive C-reactive protein, length of hospital stay from onset to onset A, length of hospital stay B, total course of disease (A+ B), average length of hospital stay, and hospitalization costs of the two groups were (38.84±0.80)℃ vs. (39.30±0.83)℃, [10.03 (3.70, 21.72)] mg/L vs. [18.51 (8.10, 42.71)]mg/L, (6.65±6.21 )days vs. (8.96±5.56) days, (6.70±2.01) days vs. (8.54±2.90) days, (13.35±6.46) days vs. (17.50±6.25) days, (7.53±2.10) days vs. (9.08±2.92) days, (3 360.27±1 320.35) yuan vs. (7 271.20±2 875.83) yuan, the observation group was higher than control group (P<0.05). Chest CT showed a significant reduction in the infection area of both lungs after treatment in both groups compared to before treatment, with statistical significance (P<0.005). A few cases of concurrent plastic bronchitis (PB) have shown good improvement in symptoms, condition, and imaging after bronchoscopic treatment.Conclusion:Starting from general clinical data such as age, highest body temperature, hypersensitive C-reactive protein, and disease course, combined with chest CT features, early identification of SMPP patients who require bronchoscopic treatment can improve the treatment effectiveness of SMPP.