Objective To explore the clinical factors influencing poor prognosis in children with severe adenovirus pneumonia, so as to provide reference for clinical treatment. Methods The clinical data of 126 children with severe adenovirus pneumonia in our hospital from July 2013 to July 2016 were retrospectively analyzed,and the clinical factors influencing poor prognosis in children with severe adenovirus pneumonia were investigated. Results There were 31 cases with poor prognosis in 126 children with severe adenovirus pneumonia. Multivariate regression analysis showed that children under one year old, multiple organ dysfunction, two or more complications and acute respiratory distress syndrome (ARDS) were independent risk factors for poor prognosis in children with severe adenovirus pneumonia. Conclusion For children with severe adenovirus pneumonia, age under one year old, multiple organ dysfunction, two or more complications, and accompanied ARDS are independent risk factors for poor prognosis. Therefore, in order to reduce the incidence of adverse events, intervention for relevant factors should be carried out in the course of clinical treatment.