Mycoplasma pneumoniae (MP) is a common pathogen that can cause communityacquired pneumonia of children. The infection of MP is usually a benign and self-limited process and can be effectively treated with macrolides. But in recent years, it was discovered that clinical symptoms and imaging findings of some cases did not improve after being regularly treated with macrolide antibiotics for more than 1 week. Their conditions were worse or protracted. Even some serious sequelae developed and resulted in refractory mycoplcasma pneumoniae pneumonia (RMPP). Cases of RMPP increase year by year and there are many difficulties for early diagnosis and treatment. This paper reviews progresses of the diagnosis and treatment of RMPP.