Abstract: OBJECTIVE To explore the clinical significance of serum cholinesterase (CHE) in evaluation of illness condition and prognosis of children with sepsis. METHODS Totally 81 children with confirmed sepsis who were treated in pediatric intensive care unit (PICU) from Jan 2013 to Aug 2015 were enrolled in the study and divided into the sepsis group with 45 cases and the severe sepsis or septic shock group (the severe sepsis group) with 36 cases, meanwhile, 50 children without infections were set as the control group.The sepsis group A and the sepsis group B were divided into the non-critically ill children (27 cases), critically ill children (32 cases), and extremely critically ill children (22 cases).The levels of CHE, procalcitonin (PCT), C-reactive protein (CRP), and albumin (Alb) were observed and compared among the children with different severities of disease and prognosis, and the correlation between the CHE and other indicators was analyzed. RESULTS There was significant difference in the level of CHE, Alb, PCT, or CRP among the three groups or among the non-critically ill children, critically ill children, and extremely critically ill children (P＜0.05).The levels of CHE and Alb of the children who died were significantly lower than those of the children who survived and the children in the control group (P＜0.05), however, the levels of PCIS, PCT, and CRP were remarkably elevated (P＜0.05).The Pearson correlation analysis showed that the CHE was positively correlated with the PCIS(r=0.74,P＜0.01; r=0.65,P＜0.01) but was negatively correlated with PCT and CRP (r=-0.79,P＜0.01,r=-0.59、P＜0.05). CONCLUSION The serum CHE level is an effective test indicator for evaluation of severity of illness condition and prognosis of the children with sepsis, and it can achieve better effect on comprehensive evaluation when combining with the levels of PCIS, PCT, Alb, and CRP.