OBJECTIVE: To evaluate the results of serum concentration monitoring of carbamazepine (CBZ) in pediatric epilepsy patients, analyze the infunential factors, and to provide reference for rational drug use in the clinic. METHODS: 2 703 pediatric epilepsy patients underwent CBZ serum concentration monitoring were collected from Xuzhou Children’s Hospital and the Affiliated Hospital of Xuzhou Medical College during May 2010-May 2015, and the serum concentration of CBZ was determined by enzyme amplified immunoassay. The effects of age, gender, drug combination and other factors on the serum concentration of CBZ were analyzed. RESULTS: Of 2 469 patients receiving single drug therapy, serum concentration of CBZ was 4-12 μg/ml in 1 939 cases (78.53%). The average serum concentration of CBZ was (4.97±2.55) μg/ml in children aged from 0-3 years, (6.18±2.55) μg/ml in those aged from 4-6 years, (7.04±2.56) μg/ml in those aged from 7-14 years and (8.26±3.32) μg/ml in those aged from 15-<18 years, with statistical significance (P<0.05). There was no statistical significance in average serum concentration of CBZ among different genders (P>0.05). Of 234 cases of combined use of sodium valproate, the proportion of children whose serum concentration of CBZ<4 μg/ml (27.35%) was higher than that of children receiving single drug therapy (18.96%); average serum concentration [(2.87±1.00)μg/ml] of them was lower than that of children receiving single drug therapy [(3.36±0.97)μg/ml], with statistical significance (P<0.05). CONCLUSIONS: Serum concentration of CBZ in pediatric epilepsy patients is related to age, drug combination and other factors. For therapy regimen development, drug dosage should adjusted according to age. Drug combination should carry out based serum concentration monitoring.