Abstract： Objective To discuss the clinical value of mechanical ventilation in treatment the children with critical hand foot and mouth disease (HFMD) complicated with neurogenic pulmonary edema.Methods The clinical manifestations,laboratorydata,treatment,and outcome of 35 children with critical HFMD complicated with neurogenic pulmonary edema were retrospectively analyzed.Results 35 cases had fever,34 cases had skin rash,33 cases had limb jitter,30 cases were easily frightened,30 cases lack of energy,34 cases had respiratory rhythm changes,18 cases vomited foam,18 cases poured pink in nose and mouth,22 cases had disturbance of consciousness,8 cases had flaccid paralysis.There were 30 cases with bilateral pulmonary exudative lesions in Chest X-ray.35 children were given mechanical ventilation based on the comprehensive treatment,and 3 cases of lower limb mobility impairments,12 cases died of pulmonary hemorrhage within 24 hours of admission,the rest was released.Conclusion Early mechanical ventilation based on the comprehensive treatment is an important measure of successful treatment in children with critical HFMD complicated with neurogenic pulmonary edema.