Objective To investigate the predictive factors of intravenous immunoglobulin (IVIG) resistance in patients with Kawasaki disease (KD).Methods The data of 279 children with Kawasaki disease diagnosed in the Affiliated Hospital of North Sichuan Medical College from January 2015 to December 2018 were analyzed retrospectively. The subjects were divided into IVIG-resistant group and IVIG sensitive group. Clinical data of the two groups were compared. Multivariate logistic regression was used to analyze the independent risk factors of IVIG resistance. ROC curve was used to analyze the predictors of intravenous immunoglobulin resistance. Results Univariate analysis showed that the time from onset to the use of IVIG, neutrophils proportion, LDL-C concentration, ALB concentration，the incidence of pericardial effusion were significantly different between the two groups. Multivariate analysis showed that shorter duration from onset to IVIG, lower ALB concentration and higher neutrophils percentage were independent predictors of IVIG resistance in Kawasaki disease. ROC curve was used to analyze the predictors of intravenous immunoglobulin resistance. When neutrophil percentage ≥77.4%, the sensitivity and specificity to predict IVIG resistance in KD patients were 72.7%, 75.7%. When albumin ≤26.7g/l, the sensitivity and specificity were 36.4%, 92.8%. The sensitivity and specificity of IVIG treatment for the first time within 5.5d after fever to predict IVIG resistance in KD patients were 89.9% and 40.9%, respectively.〖WTHZ〗Conclusion The time from onset to the first IVIG infusion, ALB and the proportion of neutrophils have a certain value in predicting the drug resistance of KD patients after the first use of IVIG.