Abstract: Objective To explore the value of transesophageal atrial pacing (TEAP) in assessing the mechanism of paroxysmal supraventricular tachycardia (PSVT) in children. Methods The electrophysiological data of 50 children with PSVT who had undergone TEAP and, at a later stage, radio-frequency catheter ablation (RFCA) examination were retrospectively analyzed from January 2008 to December 2013. Results When using the intracardiac electrophysiological study (IEPS) as the diagnostic gold standard, the sensitivity of TEAP for atrioventricular nodal reentrant tachycardia (AVNRT), left accessory pathway (LAP) and right accessory pathway (RAP) was 92.9%, 83.1% and 90% respectively; the specificity was 86.4%, 100% and 95% respectively; the accuracy was 90%, 96%, and 94% respectively. The diagnostic accuracy of TEAP for AVNRT was 92.9% (26/28), the diagnosis accuracy for slow-fast AVNRT was 100%, but 2 cases of fast-slow AVNRT were both misdiagnosed as AVRT. The diagnostic accuracy of TEAP for AVRT was 86.4% (19/22) and 3 cases were misdiagnosed as slow-fast AVNRT. Conclusions TEAP has good clinical value in finding the mechanism of PSVT and its preliminarily location in children, but it has some limitations for some types of PSVT.