Abstract: Objective： To investigate the clinical efficacy of methylprednisolone combined with conventional western medicine in the treatment of pediatric acute nephritis. Methods： 102 cases of acute nephritis children were randomly divided into two groups (51 cases each group). The control group was treated with conventional western medicine. The combined group added methylprednisolone based on the control group. The symptoms improvement， clinical efficacy and adverse reactions of two groups were compared. Results： The hematuria disappear time， proteinuria disappear time， disappearance of edema and blood pressure to return to normal time in the combined group were significantly shorter than those in the control group (P<0.05). The total effective rate was 92.16% in the combination group and 68.63% in the control group， and the total effective rate in the combination group was significantly higher than that in the control group (P<0.05). The total incidence of adverse reactions in the combination group was 11.76% and in the control group was 5.88%， there was no significant difference between the two groups (P>0.05). Conclusion： Methylprednisolone combined with conventional western medicine in the treatment of pediatric acute nephritis can effectively improve clinical symptoms， improve clinical efficacy， and will not increase the risk of adverse reactions. It is a safe and effective treatment.