Objective: To investigate the correlation between suPAR (soluble urokinase type plasminogen activator receptor) levels and imaging findings in children with severe pneumonia. Methods: 70 cases of children with pneumonia in our hospital from January 2020 to December 2020 were selected as the research object. Among them, 35 children with severe pneumonia, 22 males and 13 females, were divided into severe group, 35 children with mild pneumonia, 20 males and 15 females. The levels of suPAR, myocardial enzymes, and lung imaging results were compared between the two groups, to understand whether suPAR has sensitivity and specificity in severe pneumonia, and to analyze whether there is correlation between suPAR level andmyocardial enzyme and lung imaging results. Results: The level of suPAR in the severe group was significantly higher than that in the mild group, and the difference was statistically significant (P<0.05). The severe group was creatine kinase isoenzyme (CK-MB) and creatine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase(AST) myocardial enzyme related indicators were significantly higher than the mild group, and the difference was statistically significant (P<0.05), the two groups of children with increased density, flocculent shadows, knots, there was no significant difference in the number of segmental consolidation and patchy shadows(P>0.05). There was a significant difference in the number of atelectasis, large patchy shadows, and double lung striae between the two groups (P<0.05); suPAR level and CK- MB, CK, LDH, AST and imaging characteristics were positively correlated (P<0.05). The AUC of serum suPAR level for ROC of severe pneumonia was 0.897 (95% CI: 0.819-0.975), and the optimal cutoff value was 1.9 ng/ml. the specificity, sensitivity were 82.86 %, 85.71 %, respectively. Conclusion: The value of suPAR in the severe pneumonia group is positively correlated with myocardial enzymes; the level of suPAR is correlated with imaging findings; the higher the level of suPAR, the more critical the condition, high sensitivity and specificity in the evaluation of severe pneumonia. [ABSTRACT FROM AUTHOR]