Objective To analyze the epidemic characteristics and changing trend of pulmonary tuberculosis(PTB) in children in Guangzhou City, and provide reference for formulating scientific prevention and control measures. Methods Data of reported PTB occurrence among children aged 0-14 years in Guangzhou City from 2006 to 2020 were collected, spatial, temporal and population distribution were analyzed, the Joinpoint regression model was used to analyze the trend of disease incidence. Results A total of 1 397 PTB children aged 0-14 years were reported, accounting for 0.66% of the reported cases of PTB in the whole population. The reported incidence dropped from 7.31/100 000 in 2006 to 2.90/100 000 in 2020, and presented overall declining trend, with an average annual decline of 3.90% (AAPC=-3.90, 95%CI: -5.64﹣-2.13), the average annual decline rate of boys (AAPC=-4.74, 95%CI: -6.77﹣-2.66, P < 0.01) was faster than that of girls (AAPC=-2.86, 95%CI: -4.78﹣-0.91, P < 0.01); reported incidence of PTB in children in urban areas averagely decreased by 4.14% (AAPC=-4.14, 95%CI: -5.99﹣-2.24, P < 0.01) annually, there was no significant change in incidence in children in rural areas (β=-0.02, t=1.00, P=0.34), but the overall reported incidence was slightly lower than that of urban children; incidence of PTB in children aged 0-2 and 10-14 was relatively higher, except for the 10-14 year old group without significant change in the reported incidence of PTB, children in other age groups showed a downward trend. Conclusion Reported incidence of PTB in children aged 0-14 years in Guangzhou City generally showed a downward trend, decline trend for children in rural area and aged 10-14 years is not obvious, it is necessary to focus on strengthening the prevention and control of PTB for these children.