Objective To retrospectively analyze the therapeutic and adverse effects of imatinib (IM) on children with chronic myelogenous leukemia (CML). Methods The clinical data of 5 children who were diagnosed as CML combined with positive Philadelphia chromosome according to the MICM standard and treated with IM from Jan. 2012 to Jan. 2013 were collected. Among 5 cases, there were 2 males  and 3 females. The median age was 9 (6-11) years old. IM of 340 mg/(m2·d) was orally administrated and the median follow-up time was 25 (15-30) months. The clinical manifestations, variations of indexes of peripheral hemogram, bone marrow cytology, and molecular biology, as well as growth and development and bone metabolism were observed regularly. Results After being treated with IM, all patients attained complete hematological response (CHR) and complete cytogenetic response (CCyR) in 3 and 12 months, respectively. The serum osteocalcin level of 1 patient was one time higher than the upper limit of normal level after being treated with IM for 25 months. Indexes relevant to growth and development of other patients showed no significant abnormalities. Conclusion The therapeutic effect of IM on children with CML is significant and safe and the adverse effects should be observed through the long-term follow-up.