Abstract: Objective To compare and analyze serum amyloid A and D-dimer in children with refractory mycoplasma pneumoniae pneumonia and mycoplasma pneumoniae pneumonia and to help clinicians to diagnose RMPP children early. Methods A total of 52 children with a diagnosis of mycoplasma pneumonia who were admitted to the Department of Respiratory Medicine of Anhui Provincial Children's Hospital from January 18 to June 19 were randomly selected. Venous blood was collected immediately after admission for SAA and D-dimer of polymer levels. The above-mentioned children were treated with Azithromycin. If their body temperature was normal, cough symptoms were relieved or chest imaging examination was rechecked, the lesions were classified into ordinary MPP group; On the contrary, they were classified into RMPP group. The results of SAA and D-dimer were compared with the normal standard values, and the results of the two groups were compared. Results The early SAA level of children in the general MPP group was(11.56±5.96) mg/L, and the D-dimer level was(0.61±0.32) μg/mL. There was no statistically significant difference from the normal standard values(all P>0.05). The early SAA level of children in the RMPP group was(42.85±35.25) mg/L, and the D-dimer level was(2.82±2.06) μg/mL. There were statistically significant differences from the normal standard values(all P<0.05). The serum levels of SAA and D-dimer in the RMPP group were higher than the normal MPP group. The difference was statistically significant(P<0.05). Conclusion The increase of serum SAA and D-dimer levels in children with mycoplasma pneumonia indicates that the disease is easy to progress to RMPP.