Objective: To investigate the changes of myocardial enzymes and related risk factors after myocardial injury in children with positive rotavirus (RV) infection. Methods: The clinical data of 87 children with positive RV infection admitted to Hainan Women and Children’s Medical Center from January 2017 to April 2019 were selected as the RV group, and the clinical data of 87 children with diarrhea but negative RV test during the same period were selected as the control group. The level of creatine kinase (CK), creatine kinase isoenzymes-MB (CK-MB), lactate dehydro-genase (LDH), alanine transaminas (AST), α-hydroxybutyrate dehydrogenase (α-HBDH), cardiac troporlin I (cTnI) and cardiac troponin T (cTnT) were measured and compared between the two groups. According to electrocardiogram, color Doppler echocardiography and clinical manifestations of children, the RV group was divided into a myocardial injury group (38 cases) and a non-injury group (49 cases). The general data of the 2 groups were compared and the risk factors of myocardial injury in children with RV were analyzed. Results: The serum levels of CK, CK-MB, LDH, AST, α-HBDH, CTnI, cTnT, and ECG Qt dispersion in the RV group were higher than those in the control group (P<0.05). By univariate analysis, the proportion of serum sodium and potassium levels below normal range in RV-infected diarrhea children with myocardial injury was significantly higher than that in non-myocardial injury group (P<0.05). Logistic multivariate analysis showed that the independent risk factors for myocardial injury in children with diarrhea caused by RV infection were the decrease of serum sodium level and serum potassium level (P<0.05). Conclusion: Children with RV-positive diarrhea have a higher risk of suffering from myocardial injury, and changes in myocardial enzymatic parameters occur at an early stage. At the same time, low serum sodium and potassium can increase the risk of suffering from myocardial injury in children with RV-positive diarrhea.