Objective To study the clinical features of juvenile primary fibromyalgia syndrome (FMS). Methods Six patients with juvenile primary FMS were registered in the department. Their clinical data were assessed and compared with 36 patients with adults FMS. Results Abdominal pain was the first symptom in five of six juvenile primary FMS, diffuse aching and left knee pain were the first symptoms in one of six patients. All were misdiagnosed prior to their rheumatological evaluation. Diffuse aching, fatigue, sleep disturbances, illness changes with weather and feeling worse with exercise were existed in six juvenile FMS patients (100%), the mean pain score was 8.8 and the mean initial tender point (TP) was 13.7. Arthrodynia, subjective joint swelling, abdominal pain, irritable bowel symptoms and urinary urgency were existed in five of six patients (83%). Dysmenorrhea was present in 4(67%), depression in 3 (50%), morning stiffness in 2 (33%), paresthesias in 2 (33%) and anxiety in 2 (33%) respectively. There was no difference compared with adults FMS. Conclusion Juvenile primary FMS is a common disease and clinicians should pay more attention to it to avoid misdiagnosis.