Kawasaki disease(KD)is the most common type of pediatric vasculitis. Ten to twenty percent of children with KD do not respond to initial intravenous immunoglobulin (IVIG) treatment which called refractory Kawasaki Disease. If untreated, approximately 15% to 25% of KD patients have complications. Therefore, it is important to predict whether KD is resistant to IVIG at an early stage. We determined whether cytokines are predictors of refractory Kawasaki Disease in children. We retrospectively reviewed the medical records of 265 children diagnosed with KD who received IVIG within 10 days of fever onset at Beijing Children's Hospital between June 2018 and March 2019. Refractory Kawasaki Disease was defined as persistent or recrudescent fever beyond 36 h after IVIG. Before IVIG and 3 days after temperature normalization following IVIG treatment, the concentrations of cytokines in the serum including interferon gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), interleukin-10 (IL-10), interleukin-6 (IL-6), interleukin-4 (IL-4), interleukin-2 (IL-2) and other three conventional inflammatory mediators were measured. The patients were divided into 2 groups: IVIG-sensitive group and refractory group. Of the 265 patients, 47 (17.7%) were refractory. After treatment with IVIG, the concentrations of IFN-γ, TNF-α, IL-10 and IL-6 in both groups were significantly lower than those before treatment (P < 0.05). Before treatment, the serum IFN-γ, TNF-α, IL-10 and IL-6 concentrations were significantly different between the IVIG-sensitive group and refractory group (P < 0.05). There were no significant differences in IL-4 or IL-2 concentrations between the two groups. The area under the receiver operating characteristic curve (ROC curve) for IFN-γ was 0.781, and the cut-off value for refractory was 7.37 pg/ml, while the area under the ROC curve for IL-6 was 0.837, and the cut-off value for refractory was 70.13 pg/ml. IFN-γ, IL-6, fever duration and albumin were independent risk factors for refractory Kawasaki disease in children. IFN-γ and IL-6 were independent risk factors for refractory Kawasaki Disease in children. Children with pretreatment serum concentrations of IFN-γ >7.37 pg/ml and those of IL-6 >70.13 pg/ml were prone to refractory Kawasaki disease. Copyright © 2020. Published by Elsevier B.V.