Abstract: 　Objective　To discuss the clinical value of fever risk score in evaluation of acute fever children without obvious infection focus aged 3 months to 5 years. Methods The fever risk score was composed of fever duration, living status, daily frequency of antipyretic administration, capillary refill time, periphery white blood count, neutrophil count, C reaction protein. A total of 839 children aged 3 months to 5 years with acute fever (body temperature ≥38℃) without obvious infection focus were evaluated prospectively by fever risk score and followed up. The sensitivity, specificity, positive and negative predictive values of fever risk score were calculated. Results Among 839 children, 94 children with a score of 0 had no serious disease and were treated at home, and antibiotics were orally administered in 24 children (25.54%). Among 474 children having the scores of 1~3, 141 children were diagnosed with serious illnesses, 112 children (23.63%) were hospitalized or under observation and 248 children (52.32%) were given antibiotics. Among 271 children having the score of 4, 167 children were diagnosed with serious illnesses and 17 with critical illnesses, 271 children (100%) were hospitalized or under observation and 250 children (92.25%) were given antibiotics. There were significant differences in incidence of serious illness and usage rate of antibiotics between children with scores of 0~3 and ≥ 4 (P<0.01). If score ≥ 1 was set as cut point, the sensitivity, specificity, negative predictive value, and positive predictive value for diagnosing serious diseases were 100%, 17.70%, 100% and 41.34%, respectively. If score ≥ 4 was set as cut point, the sensitivity, specificity, negative predictive value, and positive predictive value for diagnosing critical illnesses were 100%, 69.10%, 100% and 6.27%, respectively. Conclusions The fever risk score may be an available, easy-to-use tool to evaluate the condition of acute fever without obvious infection focus in children aged 3 months to 5 years for clinic doctors.