Objective: To investigate the clinical effect of dual atomization combined with azithromycin in the treatment of mycoplasma pneumoniae pneumonia (MPP) in children. Methods: 86 children with MPP admitted to the Children"s Rehabilitation Department of our hospital from January 2023 to April 2024 were selected as the study objects. The children were randomly divided into control group and observation group by random number table method, with 43 cases in each group. The control group was treated with budesonide combined with azithromycin. Observation group was treated with dual atomizing inhalation combined with azithromycin. The clinical efficacy, C-reactive protein (CRP) level, symptom remission time and adverse reactions of the two groups were analyzed and compared. Results: The total effective rate of observation group was significantly higher than that of control group (P < 0.05). After treatment, the serum CRP level in observation group was significantly lower than that in control group (P < 0.05). The remission time of fever, cough, fatigue and pain in observation group was significantly shorter than that in control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion: Dual nebulization combined with azithromycin can reduce the level of serum CRP in children with MPP, promote the relief of symptoms and improve the therapeutic effect.