Abstract: Objective To observe the clinical efficacy of low-dose azithromycin combined with montelukast sodium in the treatment of recurrent lower respiration tract infection(RLRTI) in children. Methods Total 80 children with recurrent lower respiratory tract infection diagnosed as bacterial pneumonia admitted to the Department of Pediatrics of Huaibei People's Hospital from January 2017 to December 2018 were selected as the RLRTI group. They were divided into low-dose group and normal dose group according to the dose of oral azithromycin, 40 patients in each group. Forty children diagnosed with bacterial pneumonia in the same period were selected as control group. The low-dose group was given 5 mg/kg azithromycin and 4 mg of montelukast sodium granules on the basis of the control group. The normal dose group was treated with 10 mg/kg azithromycin and montelukast sodium granules 4 mg orally. The laboratory data of the three groups were counted. All the children's data were included in the Excel database for statistical analysis. SPSS 22.0 software was used. Statistical analysis was performed to observe the clinical symptoms, signs and prognosis of the children. Results At admission, there was a statistically significant difference in eosinophils(EOS) and total IgE between the RLRTI group and the control group(all P<0.05). After treatment, the differences in white blood cell(WBC), neutrophil(N), hypersensitive C-reactive protein(hs-CRP), procalcitonin(PCT), total IgE and hospitalization between the two groups were statistical significance(all P<0.05), and there was no significant difference in EOS(P>0.05). There was significant difference in the total effective cases between the three groups(χ²=18.813, P<0.001). There was a statistically significant difference in total adverse reactions between the low-dose group and the normal dose group(χ²=16.241, P<0.001). There was a statistically significant difference in the number of total recurrences after discharge from the three groups(χ²=9.279, P=0.010). Conclusion Low-dose azithromycin combined with montelukast sodium can significantly shorten the length of hospital stay in children with RLRTI, reduce the adverse reactions and recurrence rate of children, and reduce the time of intravenous antibiotic use and the number of hospitalizations.