AIM: To compare the therapeutic effects between azithromycin and erythromycin on Mycoplasma pneumonia in children. METHODS: Seventy_nine patients with Mycoplasma pneumonia were randomly divided into 2 groups. Forty_one patients of azithromycin group (M 22, F 19; age 7.9 a±s 1.6 a) were given azithromycin 10 mg/kg, po, qd, for 3 d, while the other thirty_eight patients of erythromycin group (M 21, F 17, age 7.8 a±2.3 a) were given erythromycin 25_30 mg/(kg·d), iv, qd for 10 d. RESULTS: The effective rates of azithromycin and erythromycin were 98 % and 95 % , respectively ( P 0.05). The marked effective rates were 76% and 53%, respectively (P0.05). The adverse reaction rates were 7% in the former group and 39% in the later group (P0.01). CONCLUSION: The marked effective rate of azithromycin was higher than that of erythromycin and with less adverse reactions in the treatment of Mycoplasma pneumonia.