Organizing pneumonia is a rare entity in childhood, particularly in previously healthy children[1].Our case was a female child with cough and shortness of breath as the first symptoms. Etiological tests indicated Mycoplasma pneumoniae infection; however, standard anti- Mycoplasma pneumoniae treatment was not effective. Follow-up medical history showed that the child had abdominal pain and vomiting in the past.Monitoring of esophageal pH for 24 hours revealed pathologic acid reflux.A lung biopsy suggested mechanized pneumonia. After standard treatment for Mycoplasma pneumoniae infection and gastroesophageal reflux, atomized budesonide suspension, and oral prednisone for nearly half a year, the chest CT lesions of the child gradually recovered and the lung function improved.