Objective：To investigate the clinical pattern and influencing factors of pediatric Crohn’s disease. Methods：A retrospective analysis was conducted on the baseline data of 59 children who were diagnosed with Crohn’s disease and admitted at the Children’s Hospital Affiliated to Nanjing Medical University，from November 2015 to November 2020. Data collected included age， sex，clinical symptoms，laboratory tests，imaging，endoscopic examinations，and treatment plans. Logistic regression models were used to analyze the influencing factors of clinical patterns in pediatric Crohn’s disease. Results：Among the 59 children，11 were lost to follow - up，and 48 completed long -term follow - up. During the follow - up，1 child died，1 underwent partial enterectomy，7（14.6%） developed new stenotic disease behavior，and 29（60.4%）had recurrence. Among the 48 children，31（64.6%）reported a decrease in the severity of intestinal symptoms，defined as the quiescent pattern，2（4.2%），5（10.4%），and 10（20.8%）had an increase in symptom severity，chronic persistent symptoms，and chronic reccurrent symptoms，defined as the severe pattern. The regression analysis indicated that wasting at the time of initial diagnosis could be a risk factor for the progression of Crohn’s disease to a severe pattern （OR=4.009，95% CI：1.047- 15.346，P=0.043）. The percentage of children with combined stenosis or perforation was significantly higher in the severe pattern than in the quiescent pattern（41.2% vs. 16.1%）. The initial treatment plan did not significantly affect the disease pattern of Crohn’s disease. Conclusion：Wasting at the time of initial diagnosis may serve as a risk factor for the progression of Crohn’s disease to a severe pattern，indicating the need for more aggressive treatment and close follow-up for these children.