Background Postural orthostatic tachycardia syndrome (POTS) is a common clinical problem in children and adolescents.The previous diagnostic approach to POTS of children and adolescents is based on a series of tests to exclude all other causes,which is time and medical resource consuming.Recently,a new diagnostic approach has been developed.The present study was designed to statistically analyze the results of clinical investigation items and the cost for the diagnosis of POTS in children patients,and evaluate cost changes in the diagnosis of POTS.Methods A total of 315 children patients were divided into two groups according to diagnosis period,including group Ⅰdiagnosed in 2002-2006 (100 cases) and group Ⅱ in 2007-2010 (215 cases) and the diagnostic item-based distribution of the cost was analyzed.The diagnostic costs were compared between two groups using SPSS17.0.Results The per-capita cost of diagnosis in group Ⅰ was (621.95±21.10) Yuan,costs of diagnostic tests (head-up tilt test,standing test,etc) accounted for 8.68％ and the exclusive tests for 91.32％.The per-capita cost of diagnosis in group Ⅱwas (542.69±23.14) Yuan,diagnostic tests accounted for 10.50％ and exclusive tests for 89.50％.Comparison of the total cost of diagnostic tests between the two groups showed significant differences (P ＜0.05).Conclusion The cost of POTS diagnosis has been declined in recent years,but the cost of exclusive diagnosis is still its major part.