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Background: Attention-deficit hyperactivity disorder (ADHD) is the most common mental and behavioral disorder in school-aged children.This study evaluated the effect of osmotic-release oral system (OROS) methylphenidate (MPH) on cognitive function and academic performance of Chinese school-aged children with ADHD.Methods: This 12-week, prospective, multicenter, open-label, self-controlled study enrolled 153 Chinese school-aged children with ADHD and 41 non-ADHD children.Children with ADHD were treated with once-daily OROS-MPH (18 mg, 36 mg, or 54 mg).The primary endpoints were Inattention/Overactivity (I/O) with Aggression Conners Behavior Rating Scale (IOWA) and Digit Span Test at week 12 compared with baseline.Secondary endpoints included opposition/defiant (O/D) subscale of IOWA, Clinical Global Impression (CGI), Coding Test, Stroop Color-word Test, Wisconsin Card Sorting Test (WCST), academic performance on teacher-rated school examinations,and safety at week 12 compared with baseline.Both non-ADHD and ADHD children received the same frequency of cognitive operational test to avoid the possible bias caused by training.Results: A total of 128 patients were evaluated with cognitive assessments.The OROS-MPH treatment significantly improved IOWA Conners I/O subscale scores at week 12 (3.8 ± 2.3) versus baseline (10.0 ± 2.4;P ＜ 0.0001).Digit Span Test scores improved significantly (P ＜ 0.0001) with a high remission rate (81.1％) at week 12 versus baseline.A significant (P ＜ 0.0001) improvement was observed in O/D subscale of IOWA, CGI, Coding Test, Stroop Color-word Test, WCST, and academic performance at week 12 versus baseline.Very few practice-related improvements were noticed in the non-ADHD group at week 12 compared with baseline.No serious adverse events and deaths were reported during the study.Conclusions: The OROS-MPH treatment effectively controlled symptoms of ADHD and significantly improved academic performance and cognitive function of Chinese school-aged children withADHD.The treatment was found to be safe and generally well-tolerated over 12 weeks.Trial Registration: ClinicalTrials.gov, NCT01933880;https://clinicaltrials.gov/ct2/show/NCT01933880?term=CONCERTAATT4099&rank=1