Objective To analyze the imaging findings of CT in children with refractory pneumonia. Methods From July 2014 to July 2016, 50children with mycoplasma pneumonia in our hospital were selected as study subjects. Children with refractory pneumonia were included into the refractory group while children withcommonpneumonia were included into the common group. All subjects underwent CT, and the general data were compared between the two groups. The imaging findings of CT were analyzed and compared between the two groups. Results The gender and incidence of pulmonary ralesshowed no significant differences between the two groups (P>0.05) while age and duration of fever of the refractory group were larger and longer than those of the common group (P<0.05). Among the 50 children with pneumonia, there were 37 cases with unilateral lung lobe lesions, 13 cases with bilateral lesions, 22 cases with single segment lesions and 28 cases with double segments lesions. The incidence rate of unilateral lung lobe lesions(74.0%) was higher than that of bilateral ones (26.0%), and the incidence rate of double segments lesions (56.0%) was higher than the single segment lesions (44.0%). The lesions mainly manifested as large-are solid shadow, spotlike or patchy solid shadow, pleural effusion, scattered spots and patchy shadow, involving the left lung and upper, middle and lower lobes of right lung. The pleural effusion, pleural thickening and extrapulmonary changes in the refractory groupwere significantly more than those in the common group, and the incidence of tree-in-bud signs in the refractory group was lower than that in the common group(P<0.05). Conclusion The duration of fever in children with refractory pneumonia is long and the age of children is relatively higher. The main findings of CT include pulmonary segment consolidation, with a small amount of pleural effusion and pleural thickening. The tree-in-bud signs in children with refractory pneumonia are fewer than in children with common pneumonia, which can be used as the basis for clinical diagnosis.