目的　探讨儿童期海马病变病因、临床表现、诊断和磁共振成像（ ＭＲＩ） 的改变。方法　对５ 年来ＭＲＩ检查有海马改变的２１ 例患儿进行回顾，分析ＭＲＩ改变及与临床的关系。结果　儿童期海马病变临床表现有抽搐、头痛、智力低下等。临床诊断癫痫最多见，共９ 例，其次有脑发育不良、多发性硬化。ＭＲＩ表现海马异常信号８例，海马萎缩７ 例，海马回发育不良５ 例，海马占位１ 例。结论　儿童期海马病变致病原因多种多样，临床表现以抽搐发作、头痛最多见。诊断以癫痫最多见，ＭＲＩ结果海马区异常信号占首位。 Objective To investigate the etiology, clinical manifestations, diagnosis and changes of magnetic resonance imaging (MRI) in childhood hippocampal lesions. Methods Twenty-one children with hippocampal changes after MRI examination in 5 years were retrospectively analyzed, and the relationship between MRI changes and clinical features was analyzed. Results The clinical manifestations of childhood hippocampal lesions were convulsions, headache, mental retardation and so on. The most common clinical diagnosis of epilepsy, a total of 9 cases, followed by brain dysplasia, multiple sclerosis. MRI showed abnormal signal of hippocampus in 8 cases, hippocampus atrophy in 7 cases, hippocampus back dysplasia in 5 cases, hippocampus occupying in 1 case. Conclusion There are many causes of pathological changes in childhood hippocampal lesions, the clinical manifestations of seizures, the most common headache. The most common diagnosis of epilepsy, MRI results in the first place of abnormal signals in the hippocampus.