Abstract: Objective To explore the therapeutic effect of anti-thyroid drugs (ATD) and 131I in children with Graves’s disease. Methods 218 cases of children with Graves disease were randomly divided into group 131I and ATD treatment group,131I group was given small doses of 131I (1~3 mci) treatment, ATD group received regular treatment with anti-thyroid drugs from 1 to 1.5 years. They were all followed up for 12 and 18 months after treatment. The relationship between age, TGAb and TMAb positive rate, thyroid weight and the efficacy of 131I were analyzed. Results The cure rate of hyperthyroidism in 131I treatment group was significantly higher than that of ATD group (P <0.01), but the hypothyroidism rate in 131I treatment group was higher than that of ATD group (P <0.05). The hypothyroidism rate and cure rate in patients with TGAb and TMAb strong positive group were higher than that of non strong positive group (P<0.05). The hypothyroidism rate in children with age less than 10 years old was higher than that of age between 10 to 14 group (P<0.05). The hypothyroidism rate in patients with thyroid weight less than 45 grams group was higher than that of thyroid weight more than 45 grams group (P<0.05). Conclusions 131I treatment for children's hyperthyroidism is better than that of ATD, and could be selectively applied in clinical treatment.