Objective To investigate the application effect of Inosine Tablets combined with Topiramate in children with transient tic disorder (TTD). Methods The clinical data of 86 children with TTD admitted to the Outpatient Department of Jiangmen Central Hospital of Guangdong Province from February 2019 to February 2021 were retrospectively analyzed. They were divided into a control group (43 cases) and an observation group (43 cases) according to different treatment methods. The children in the control group were treated with Inosine Tablets, and the children in the observation group were additionally treated with Topiramate. Both groups were treated for 24 weeks. The clinical efficacy, Yale global tie severityb scale (YGTSS) score, attention deficit hyperactivity disorde (ADHD) score, daily tic times and adverse reactions were compared between the two groups. Results The total effectiveness rate of treatment in the observation group was higher than that in the control group, and the difference was statistically significant (P<0.05).There was no significant difference in the YGTSS score between the two groups before treatment (P>0.05). The items and total YGTSS scores of the observation group were lower than those before treatment, and the differences were statistically significant (P<0.05). The items and total YGTSS scores in the observation group after treatment were lower than those in the control group, with statistical significances (P<0.05). There were no significant differences in ADHD scores between the two groups before treatment (P>0.05). After treatment, the scores of attention deficit, hyperactivity and impulsivity and total ADHD scores of the two groups were lower than those before treatment, the differences were statistically significant (P<0.05). The attention deficit, hyperactivity and impulsivity scores and total ADHD score of the observation group were lower than those of the control group after treatment, the differences were statistically significant (P<0.05). There was no significant difference in the number of daily tic before treatment between the two groups (P＞0.05). The number of daily convulsions in the two groups after treatment was less than that before treatment, the difference was statistically significant (P＜0.05). The number of daily convulsions in the observation group was less than that in the control group, and the difference was statistically significant (P＜0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P＞0.05). Conclusion Inosine Tablets combined with Topiramate can improve the therapeutic effect of TTD in children, reduce the YGTSS score and ADHD score, and reduce the number of daily tics. It is safe and reliable, and is worthy of wide application.