Objective: To analyze the changes of ultrasonic signs and their relationship with clinicopathological characteristics in children with hepatoblastoma. Methods: A retrospective analysis was performed on the ultrasonic and pathological data of 36 children with hepatoblastoma admitted to the hospital between January 2018 and January 2023. The changes of ultrasonic signs in children with different pathological types (complete epithelial cell type

non-teratoid mixed type

teratoid mixed type) were compared. Results: In the 36 children with hepatoblastoma

results of ultrasound examination showed that among the 13 children with complete epithelial cell type

there were 7 cases with tumors located in right lobe of liver

3 cases in left and right lobes

2 cases in left lobe and 1 case in caudal lobe. The average size of tumors was (286.34±23.75) cm3

there were 10 cases with regular and single lesions

9 cases with boundary-clear lesions and 11 cases with necrosis and cystic lesions in irregular tumors. Among the 9 patients with non-teratoid mixed type

there were 4 cases with tumors located in right lobe of liver

2 cases in left and right lobes

2 cases in left lobe and 1 case in caudal lobe. The average size of tumors was (282.59±21.98) cm3

there were 6 cases with regular and single lesions

5 cases with boundary-clear lesions and 7 cases with necrosis and cystic lesions in irregular tumors. Among the 14 children with teratoid mixed type

there were 8 cases with tumors located in right lobe of liver

3 cases in left and right lobes

2 cases in left lobe and 1 case in caudal lobe. The average size of tumors was (284.61±22.07) cm3

there were 11 cases with regular and single lesions

10 cases with boundary-clear lesions and 12 cases with necrosis and cystic lesions in irregular tumors. There was no significant difference in lesion characteristics among children with different pathological types (P>0.05). The proportion of tumor echo in children with complete epithelial cell type was higher than that in children with teratoid mixed type

and which in children with non-teratoid mixed type was higher than that in children with teratoid mixed type. The calcification degree in children with complete epithelial cell type was significantly milder than that with the other two pathological types (P<0.05). Conclusion: The pathological types of children with hepatoblastoma can be preliminarily determined by analyzing the changes of ultrasonic signs (tumor calcification

echo proportion).