Objective To investigate the occurrence trend and risk factors of recurrent respiratory tract infection during the ifrst year after Mycoplasma pneumoniae pneumonia (MPP) in children. Methods The clinical data of 133 children complete-ly recoved from MPP and one year follow-up after MPP were included in this study, MPP IgM IgG double antibody titer were measured in different time slots (3 month, 6 months, 9 months, 12 months) after discharge. Information on frequency of recurrent respiratory tract infections, respiratory tract infection site, and drug use within one year were collected. Possible factors affecting the occurrence of recurrent respiratory tract infection were analyzed by means of single factor and multi factor analyses. Results In 133 patients, the recurrent rate was 31.58%in the ifrst year;aged 3-6 years old (OR=2.29,95%CI:1.13~4.64), or continuous positive or negative to positive antibodies (OR=4.47,95%CI:1.47~13.65), or low CD4/CD8 (OR=10.26,95%CI:3.30~31.90), or low IgA (OR=1.90,95%CI:1.06~3.40) is independent risk factor of recurrent respiratory tract after MPP;immune enhancer therapy is an independent protective factor (OR=0.29,95%CI:0.11~0.78). Conclusions Immune function disorders in the ifrst year after MPP were independent risk factors of recurrent respiratory tract infection. MP antibody positive without clinical symptoms and sustained antibody positive can not prevent the recurrence of respiratory tract infection without use of antibiotics. Immune enhancer was advocate to adjust immune function and reduce the incidence of repeated respiratory tract infection.