ObjectiveTo understand the clinical features and prognosis of children with severe viral encephalitis(SVE), evaluate the related factors affecting prognosis. MethodsClinical data of 102 children with SVE in pediatric neurological ward and pediatric intensive care unit in Hunan Children’s Hospital between January 2014 and January 2016 were analyzed retrospectively. According to prognosis, children were divided into good prognosis group(n=24, children’s Glasgow outcome scale［CGOS］: 4-5) and poor prognosis group(n=78, CGOS:1-3), clinical data of two groups of children were compared, risk factors affecting the prognosis of SVE children were analyzed. ResultsIn good prognosis group, 15 cases were cured and 9 had mild sequelae; in poor prognosis group, 14 cases died， 25 had severe sequelae, and 39 had moderate sequelae. The duration of fever and length of hospital stay in good prognosis group were both shorter than poor prognosis group, difference was statistically significant (both P＜0.05). Multivariate unconditioned logistic regression analysis showed that adverse factors for prognosis of SVE were as follows: convulsive status, respiratory failure，longer fever period(>5 days), severely abnormal electroencephalogram(EEG), head magnetic resonance imaging (MRI) lesions involving more than two sites or lesions involving the infratentorial, and stress hyperglycemia, odds ratio(OR) were 13.468, 4.580, 2.378, 10.196, 3.012, and 6.316 respectively. ConclusionSVE is a serious threat to quality of children’s life, convulsive status, respiratory failure，longer fever period, severely abnormal EEG, head MRI lesions involving more than two sites or lesions involving the infratentorial, and stress hyperglycemia are risk factors for prognosis of SVE in children.