Objective To explore the clinical manifestations and pathogenic detection results of children scarlet fever. Methods A total of 40 children patients with scarlet fever in our hospital from December 2017 to November 2018 were selected. The clinical manifestations and rash characteristics were analyzed. The throat swab specimens of children patients were isolated and cultured. Suspected colonies were given pathogen screening and identification. Results Among the 40 children patients with scarlet fever in this study, the rate of common type was 47.50%, and the rate of light type was 52.50%, and there was no sepsis type, poisoning type and surgical type. The clinical symptoms manifestations of children patients showed 20 cases of fever (50.00%) 33 cases of sore throat (82.50%) and 36 cases of angina (90.00%). 24 cases (60.00%) of children patients were with typical rash, and 16 cases (40.00%) were with atypical rash. Among 40 cases of children patients, 38 cases (95.00%) were with 0.3cm follicular needle tip papules. Throat swab culture of 40 children patients showed 27 cases of positive group A β-type streptococcus hemolyticus, and the positive rate was 67.50%. Conclusion The clinical manifestations of children scarlet fever tend to be mild, and the state of rash has certain characteristics, and the pathogenic detection has a certain role in clinical diagnosis.