Abstract: Objective　To identify the clinical risk factors of refractory Mycoplasma pneumoniae pneumonia (RMPP) and their values in early diagnosis. Methods The retrospective analysis of clinical data was conducted in 142 children with Mycoplasma pneumoniae pneumonia (MPP) admitted to Changhai Hospital of Second Military Medical University from Jan. 2012 to Jan. 2014. All children were divided into two groups, RMPP group (n=112) and MPP group (n=30). The comparison was made between two groups in clinical data. The factors were analyzed by the multifactor logistic regression. Results As compared to MPP, RMPP had longer fever duration, the higher ratios of large consolidation shadows, extrapulmonary complications and increased CRP level (P<0.05). The results of logistic regression indicated that the clinical risk factors included large consolidation shadows (OR=6.57, 95%CI: 2.10-20.56), extrapulmonary complications (OR=11.66, 95%CI: 2.42-56.08) and CRP (OR=14.87, 95%CI: 2.67-82.79) (P<0.01). Conclusions Large consolidation shadows, extrapulmonary complications and CRP are clinical risk factors of RMPP. CRP elevation and lung imaging changes are valuable in early diagnosis of RMPP.