Objective: Summarize the clinical characteristics of pediatric paragonimiasis, explore the causes of misdiagnosis, and provide reference for clinicians to diagnose and treat children's paragonimiasis. Methods: Retrospective analysis of the clinical data of 104 cases of paragonimiasis in children diagnosed by Kunming Children's Hospital from January 2012 to December 2022. The data of epidemiology, clinical symptoms, laboratory examination, imaging examination, diagnosis and treatment, economic burden, prognosis and other characteristics of the child were collected. The children were divided into six groups based on clinical characteristics: chest-lung type, abdominal type, subcutaneous mass type, cerebrospinal cord type, hidden type and mixed type. General information, laboratory examination and immunologic test were compared and analyzed for the children. Results: Among 104 children with paragonimiasis, 81 were male(78%) and 23 were female(22%). The peak incidence was in the school-age group. Analysis of the general data of the 6 different types of paragonimiasis revealed that there was a statistically significant difference in the distribution of males among the 6 different types of patients(P=0.031). Laboratory test analysis showed that 77 cases(74.0%) had elevated white blood cell count, 102 cases(98.1%) had elevated eosinophil counts, 82 cases(78.8%) had elevated IgG in humoral immunity, and 29 cases(27.9%) had elevated erythrocyte sedimentation rate(ESR). Among the different types of paragonimiasis patients, the differences in ESR were statistically significant(P=0.035). Among the 89 children who underwent paragonimiasis antibody enzyme-linked immunosorbent assay(ELISA), of which 80 cases(90%) were positive for paragonimiasis antibodies, and 20 cases(25%) were positive for paragonimiasis antibody combined with other parasitic antibodies. 80 children were subjected to rapid immunological testing(DIGFA) by gold standard filtration, and the positive rate was 100%. The imaging feature analysis showed that the main manifestations of the patients were pleural effusion and pleural thickening, accounting for 76 cases(73.1%) and 47 cases(45.2%), respectively. Conclusion: The increase in the number of eosinophils is accompanied by clinical manifestations of paragonimiasis infection(some patients have hidden onset of the disease). The auxiliary examination suggests corresponding imaging changes, especially multi-plasmic membrane cavity fluid accumulation and lung lesions. The DIGFA is positive for paragonimiasis antibody, which is a reliable and timely diagnostic method for paragonimiasis.