Objective To study the Influence of glucocorticoid on therapeutic effect of children with Kawasaki disease (KD) during acute stage. Methods 92 children with KD admitted from January 2018 to January 2023 were included and randomly divided into conventional group and combined group with 46 cases in each group. The conventional group was treated with human immunoglobulin + aspirin, and the combined group was given glucocorticoid on the basis of the conventional group. Both groups of patients were treated for 2 weeks. The disappearance times of clinical symptoms (fever, mucosal congestion, limb swelling) after medication, anti-platelet aggregation-related factors ［platelet count (PLT), white blood cell count (WBC), erythrocyte sedimentation rate (ESR)］, inflammatory factors ［growth differentiation factor-15 (GDF-15), macrophage migration inhibitory factor (MIF), serum high mobility group box 1 (HMGB1)］ and immune function (CD4+, CD8+) and coronary artery diameter before and after treatment and occurrence of adverse drug reactions during treatment were compared between the two groups of KD children. Results The disappearance times of clinical symptoms such as fever, mucosal congestion and limb swelling in combined group were significantly shorter than those in conventional group (P<0.05). After 2 weeks of treatment, the levels of PLT, WBC, ESR, GDF-15, MIF, HMGB1 and CD4+ in both groups were significantly lower than those before treatment, and the levels were significantly lower in combined group than those in conventional group (P<0.05). The level of CD8+ in KD children in the two groups was significantly higher than that before treatment, and the level in combined group was significantly higher compared with that in conventional group (P<0.05). After treatment, the coronary artery diameter in the two groups was significantly reduced compared with that before treatment, but there was no statistically significant difference between the two groups (P>0.05).There was no statistically significant difference in the total incidence rate of adverse reactions between the two groups (P>0.05). Conclusion Glucocorticoid combined with human immunoglobulin in the treatment of children with KD can promote the clinical symptom disappearance, help to enhance the anti-platelet aggregation ability and reduce the inflammatory response