Objective To analyze the clinical significance of immunoglobulin and CD3+, CD4+, CD19+, CD4+/CD8+ in the condition and prognosis of children with refractory mycoplasma pneumonia. Methods A total of 95 children with mycoplasma pneumonia admitted to Anshan Central Hospital from January 2020 to May 2021 were divided into refractory group (35 cases) and ordinary group (60 cases) according to the severity of disease. The refractory group was refractory, and the ordinary group was common. Another 50 healthy children were selected as the control group. The levels of immunoglobulin and CD3+, CD4+, CD19+, CD4+/CD8+ in the three groups were compared. Children with refractory mycoplasma pneumonia were divided into good prognosis group and bad prognosis group according to prognosis, and the immune indexes of the two groups were compared. Results The levels of CD3+, CD4+ and CD4+/CD8+ in the mycoplasma pneumonia group were lower than those in the control group, while the levels of CD8+, CD19+, immunoglobulin A (IgA), immunoglobulin G (IgG) and immunoglobulin M (IgM) were higher than those in the control group, the differences were statistically significant (P＜0.05). The levels of CD3+, CD4+ and CD4+/CD8+ in the refractory group were lower than those in the normal group, while the levels of CD8+, CD19+, IgA, IgG and IgM were higher than those in the normal group, the differences were statistically significant (P＜0.05). The levels of CD3+, CD4+ and CD4+/CD8+ in the good prognosis group were higher than those in the adverse group, while the levels of CD8+, CD19+, IgA, IgG and IgM were lower than those in the adverse group, the differences were statistically significant (P＜0.05). Conclusion Cellular immunological indicators and humoral immune indicators can effectively predict the severity of the disease in children with mycoplasma pneumoniae pneumonia, and have high application value.