Abstract: 　Objective　A meta-analysis method was used to evaluate the relationship between serum vancomycin trough concentration and its clinical efficacy and safety in children. Method　Database of PubMed, ELSEVIER, Web of Science, Medline, Clinicaltrials.gov, Cochrane Library, CBM, CNKI, and Wanfang were searched. And research data of vancomycin in the treatment of infective diseases in children were collected. Cochrane system was used to evaluate the quality of the included literature, and the feature information was extracted and meta-analysis was carried out. Outcomes include clinical efficiency, the incidence of renal toxicity, liver toxicity and ototoxicity, and the fatality rate. Results　A total of 20 articles were included, containing 3204 children treated with vancomycin. The results of meta-analysis showed that there were higher clinical efficiency (OR=2.59, 95% CI:1.33~5.05, P<0.05), higher incidence of renal toxicity (OR=3.63, 95% CI:2.31~5.7, P<0.05), higher incidence of ototoxicity (OR=2.43, 95% CI:1.25~4.72, P<0.05), and higher mortality (OR=2.41, 95% CI:1.13~5.14, P<0.05) in the trough concentration>10 μg/mL group than in vancomycin trough concentrations ≤10 μg/mL. The vancomycin trough concentrations were not related to hepatotoxicity. Subgroup analysis showed that children with trough concentration >15 μg/mL had higher renal adverse reaction (OR=2.54, 95% CI:1.59~4.08, P<0.05) than those with vancomycin trough concentrations at 10~15 g/mL, and there was no significant difference in clinical efficacy (OR=0.59, 95% CI:0.17~2.03, P>0.05). Conclusion Vancomycin trough concentration ≤10 μg/mL has poor clinical efficacy with low incidence rate of adverse reaction. Trough concentration >15 μg/ mL has a higher incidence of adverse reaction, and the effect of clinical treatment is equal to that of trough concentration 10~15 g/mL. Therefore, the trough concentration of 10~15 μg/mL is suitable.