Objective　To explore the clinical characteristics, diagnosis, treatment and prognosis of thrombotic microangiopathy (TMA) in children. Method　The clinical data of 17 TMA children admitted from July 2008 to December 2017 were retrospectively analyzed. Results　Eight male and nine female children with an average age being 4.5±1.8 years had hemolytic anemia, thrombocytopenia and acute renal insufficiency,. All the 17 children were treated with plasma therapy, dialysis, hormones and immunosuppressive agents. Ten children were cured or discharged after improvement. Two children were treated in other hospitals and 2 gave up treatment and 3 died. Conclusion　TMA is an acute clinical syndrome characterized by microvascular hemolytic anemia, thrombocytopenia and organ involvement caused by platelet thrombosis in microcirculation. Early diagnosis and individualized comprehensive treatment can improve the prognosis.