Objective：To investigate the high risk factors of giant coronary artery aneurysms（GCAA） complicated with Kawasaki dis－ease（KD） and to provide references for prevention and follow up of GCAA. Methods：Totally 3 191 patients with KD from September 2003 to September 2011 in our hospital were enrolled including 34 patients complicated with GCAA（GCAA group），76 patients complicated with small or medium coronary artery aneurysms（CAA，small or medium CAA group），2 020 patients complicated with coronary artery dilation（CAD，304 patients were selected randomly as CAD group） and 1 061 patients with non coronary artery lesion （NCAL，216 patients were selected randomly as NCAL group）. Statistical description of epidemiological data and cardiac involvement of patients in the four groups was made. Chi-square test was used to analyze the possible risk factors of GCAA. Multiple Logistic re－gression analysis was performed to estimate the OR and 95%CI for the risk factors. Results：In the GCAA，small or medium CAA，CAD，NCAL group，the numbers of male，female cases were 27 and 7，54 and 22，212 and 92，113 and 103，respectively；their average ages were （4.8 ± 3.8） years，（2.8±2.6） years，（2.4±1.9） years，（3.0±2.2） years，respectively. Chi-square test showed that the fac－tors of age <1 year or ≥5 years，febrile days >14 d，white blood cell counts≥20.00×109/L，platelet counts≥800×109/L，hemoglobin <90 g/L，lower hematokrit，C-reactive peptide>100 mg/L，erythrocyte sedimentation rate（ESR） >100 mm/h，accepting the first intra－venous immunoglobulin（IVIG） until the 11 d after finishing the disease course，insensitivity to initial treatment with IVIG were as－sociated with CAA. Multiple Logistic regression analysis showed that ESR >100 mm/h[OR=2.946，95%CI（1.167，7.439），P=0.022]，febrile days >14 d [OR=3.317，95%CI（1.302，8.450），P=0.012] were the independent risk factors of GCAA. Conclusions：Febrile days>14 d，ESR >100 mm/h are the independent risk factors of GCAA.