Objective To investigate the application value and effect of single balloon enteroscopy (SBE) in long-term follow-up of small intestinal polyps in patients with Peutz-Jeghers syndrome (PJS). Methods The clinical data of 10 patients with PJS who were admitted to the Gastroenterology Department of Xinhua Hospital from January 2011 to June 2024 and received long-term follow-up with SBE were retrospectively analyzed. Results Among the 10 children with PJS, there were 7 boys and 3 girls. The median age at diagnosis of PJS was 9.5 (6-16) years. The median follow-up time was 132 (95-137) months, and the median follow-up interval was 17.3 months. A total of 46 SBE examinations were performed (29 via mouth and 17 via anus), and 157 polyps were treated. The median number of polyps >15 mm in diameter treated in each patient was 7 (1-13). After SBE follow-up treatment, the abdominal symptoms and anemia of the patients were significantly improved. During the follow-up period, only 1 patient needed surgery due to intussusception, which may be related to the long follow-up interval and irregular follow-up. Postoperative sore throat was found in all patients with transoral enteroscopy (100%). Abdominal distension after SBE was observed in 8 cases (17.4%). Perforation occurred in 1 case (2.2%) and improved after conservative medical treatment. Conclusions Long-term regular follow-up and preventive resection of small intestinal polyps with SBE in PJS patients is a safe and effective method, which is of great significance for improving abdominal symptoms and reducing the risk of intussusception and surgery.