Objective:To observe the efficacy and safety of high dose methylprednisolone in the pulse therapy for infantile spasms. Methods:Totally 70 cases of infantile spasms were randomly divided into the conventional dose group and high dose group with 35 ones in each according to the random number table. High dose group was given methylprednisolone pulse therapy for the first 5 days, and then received the conventional dose treatment. The conventional dose group received prednisone tablets orally. The treatment course was 8 weeks. The ECG outcome, efficacy and incidence of adverse reactions were observed and compared between the groups, and the efficacy of pulse therapy for the patients with different causes and different course was also studied. Results:The total effective rate of high dose group was 94. 29%, which was significantly higher than that of conventional dose group (71. 43%), and the difference was statistically significant (P<0. 05). The EEG outcome between the groups had not statistical significance (P>0. 05). The incidence of adverse reactions in high dose group was wigher, while the difference was not significant (P>0. 05). The efficacy of pulse therapy for different causes and different course had no statistically significant difference (P >0.05). Conclusion: High dose methylpred-nisolone pulse therapy can effectively improve clinical efficacy for infantile spasms, which shows no effect on the safety of patients.