Objective To investigate the clinical characteristics of Chlamydia pneumoniae pneumonia in children and enhance awareness, diagnostic accuracy, and therapeutic management of this condition. Methods A retrospective analysis was performed on clinical data from children diagnosed with Chlamydia pneumoniae pneumonia admitted to the Department of Respiratory Medicine between July 2024 and May 2025. Results A total of 39 patients were included, comprising 20 males and 19 females, with a median onset age of 10.9 years (interquartile range: 7.8-12.5). The mean duration of illness prior to admission was (11±5) days, and the median hospital stay was 6 days (range: 4-6). All patients presented with cough; fever, chest pain, and chest tightness were observed in some, while only a few exhibited abnormal pulmonary auscultation findings. Chest CT revealed round high-density opacities or patchy consolidations, predominantly subpleural in distribution. Air bronchograms and halo signs were noted in a subset of cases. Unilateral lung involvement occurred in 34 patients, bilateral in 5. Laboratory findings showed normal white blood cell count, neutrophil percentage, procalcitonin, and IL-6 levels. Elevated C-reactive protein was present in 12.8% of patients, increased erythrocyte sedimentation rate in 50%, and elevated IL-10 in 73.7%. All 39 patients had positive serum IgM antibodies against Chlamydia pneumoniae; among them, 7 had positive Chlamydia pneumoniae nucleic acid detected by next-generation sequencing in bronchoalveolar lavage fluid, and 1 had a positive nucleic acid test in sputum obtained from an outside institution. Most patients received azithromycin monotherapy, followed by doxycycline; 5 patients additionally received glucocorticoids. Clinical recovery was achieved in all 36 follow-up cases. Conclusions Pediatric Chlamydia pneumoniae pneumonia may manifest without fever, with cough as the sole presenting symptom. Characteristic imaging features include subpleural, mass-like consolidations often accompanied by peripheral air bronchograms and occasionally halo signs. Definitive diagnosis relies on serological IgM detection or nucleic acid testing. Treatment with azithromycin or doxycycline is effective.