Abstract: Mycoplasma pneumoniae pneumonia （MPP） is a common cause of community-acquired pneumonia in children aged 5 and older in China. Although most affected children have favorable clinical prognosis, some cases can escalate into severe MPP due to risk factors such as pathogen resistance or co-infections, etc. These severe cases significantly jeopardize the lives of children and may lead to diverse long-term sequelae. In response to this challenge, the Children’s Medical Center of the Third Affiliated Hospital of Sun Yat-sen University, integrating current guidelines, expert consensus, and its extensive clinical experience, has devised the “412” cluster treatment strategy. This comprehensive approach encompasses treatments for anti-infection, anti-inflammatory storm, anticoagulation and antioxidant stress. Additionally, it seamlessly integrates traditional Chinese medicine with western therapies, featuring bundled respiratory management and follow-up care. This strategy provides a valuable reference for the diagnosis and treatment of severe MPP in children.