Abstract: Objective: To analyze the clinical and imaging features of children with posterior reversible encephalopathy syndrome(PRES). Methods: Clinical data and imaging results of the patients with PRES diagnosed in Children's Hospital of Chongqing Medical University from January 1st, 2012 to April 30th, 2019 were retrospectively reviewed. The correlations between recorded scores of clinical manifestations, imaging findings and gender, age, hypertension and cytotoxic drugs were analyzed. Results: A total of 55 children were included into the analysis with 33 males(60%) , and the median age of onset was 10(1~15) years old. The common clinical manifestations were convulsive seizures (92.7%) and dizziness and headache (52.7%). There were 32 children with convulsion as the first manifestation. After removing risk factors and performing symptomatic treatment, the symptoms of 49 cases (89.1%) were relieved. Seizures recurred in 2 children and only 1 child developed cerebral hernia. In univariate analysis, scores of neurological symptoms were higher in girls than that of boys (6 vs 4, P<0.05). Age, severity of hypertension, glucocorticoids and cytotoxic drugs were not correlated with severity of clinical symptoms and imaging results. Conclusion: The most common clinical manifestation of children with PRES is convulsion. The clinical neurological symptoms of female children may be more serious than those of male ones. For children with hypertension or using glucocorticoids or immunosuppressants, convulsions should be kept vigilant by pediatricians.