Abstract: Objective　To explore the influencing factors of symbolic play ability in children with autism spectrum disorder (ASD) and its application in the early diagnosis and identification of ASD. Method　The clinical data of 123 children who visited developmental behavior pediatric clinic from April 2015 to August 2017 were reviewed. There were 66 cases of global developmental delay (GDD) including 36 cases of ASD with GDD and 30 cases of simple GDD, and 57 cases without GDD including 31 cases of ASD without GDD and 26 cases of developmental language disorder (DLD). The results of symbolic play test (SPT) and Gesell developmental scale (Gesell) among different groups were compared, and the related influencing factors of symbolic play ability and its role in classification of diseases were explored. Results　In GDD children, the development month of symbolic play test (SPT) in ASD children with GDD was lower than that of the children with simple GDD, and the proportion of SPT development month retardation was higher than that of the children with simple GDD. In children without GDD, SPT development month in ASD children without GDD was lower than that of DLD children, and the proportion of SPT development month retardation was higher than that of DLD children, and there were statistical differences (P<0.05). In ASD children, the ability of symbolic play is positively correlated with the developmental quotients in the areas of Gesell (r=0.393~0.630， P<0.01), and had a significantly negative correlation with the ASD symptoms (r=−0.390~−0.387， P<0.01). Regression analysis showed that the symbolic play ability can distinguish between GDD and ASD combined with GDD independently in GDD children (OR=0.39, 95%CI: 0.745~0.992, P=0.034). But in ASD children without GDD, there was no significant difference (P>0.05). Conclusion　There is a developmental delay of symbolic play ability in ASD children, compared with the GDD and DLD children at comparable development level. SPT could be used to differentiate ASD from GDD,  and played an important role in early diagnosis and intervention in ASD.