Objective To determine the risk factors for coronary artery lesions (CALs) in patients with Kawasaki disease (KD). Methods The clinical records of 2 331 patients with KD from January 2005 to December 2014 in Beijing Children′s Hospital, Capital Medical University were retrospectively analyzed.The relationship between the following factors and CALs was analyzed by univariate and multivariable Logistic regression analysis: age, gender, incomplete KD, total fever duration, intravenous immunoglobulin(IVIG) treatment resistance, white blood cell count, C-reactive protein(CRP), platelet count, sodium and albumin. Results The incidence of CALs was 36.0%(840/2 331 cases). Univariate Logistic regression analysis indicated that male patients, incomplete KD, total fever duration≥10 days, IVIG treatment resistance, CRP >100 mg/L, platelet count >300×109/L and albumin 100 mg/L (OR=1.556, 95%CI 1.274-1.900, P<0.001) and albumin<35 g/L (OR=1.665, 95%CI 1.323-2.096, P<0.001) were the independent risk factors for CALs. Conclusions The main damage in patients with KD is CALs.The male children with KD, incomplete KD, total fever duration≥10 days, CRP>100 mg/L and albumin<35 g/L were prone to CALs. Key words: Kawasaki disease; Coronary artery lesions; Risk factor