Objective: To explore the related risk factors, clinical characteristics and its reasonable preventive measures of gastrointestinal perforation caused by magnetic foreign body in children. Methods: The clinical data of 17 children with magnetic foreign body ingestion in General Surgery Department of Children’s Hospital Affiliated to Nanjing Medical University from January 2014 to December 2018 were summarized, and the induction factors, age distribution, clinical symptoms, physical signs, results of auxiliary examinations and intraoperative performance of children were analyzed. Results: A total of 17 pediatric patients took imaging examinations every 24 hours after admission to observe whether the foreign body moved. Two cases with continuous movement of foreign bodies without acute abdominal manifestations and positive abdominal signs discharged by themselves after conservative treatment. Among the 15 cases of foreign body immobility in continuous photography 13 cases had acute abdominal pain, 11 cases had elevated C-reactive protein, total leucocyte count and percentage of neutrophils, and 2 cases had no significant change. And 13 cases were confirmed as gastrointestinal tract injury by emergency operation, including 2 with gastric injury, 1 with duodenal injury, 5 with jejunal injury, 8 with ileal injury, 3 with ileocecal injury and 1 with colon injury. It was confirmed that there were 5 cases of gastrointestinal perforation with peritonitis, 1 case of intra-abdominal hernia and other 7 cases of simple gastrointestinal fistula during operation. In the other 2 cases without digestive tract injury, neither of them showed abdominal pain, and the total leucocyte count was increased in one case. Postoperative follow-up demonstrated that the growth, development and psychological status of the children in this group were not significantly affected whether the operation was performed or not. Conclusion: Acute abdominal pain and non-movement of foreign bodies on continuous dynamic radiography are the alarm signs of digestive tract injury caused by ingestion of multiple magnetic foreign bodies in children. For these children, even if there are no obvious signs of peritoneal irritation, priority should be given to gastrointestinal perforation and active surgical exploration is necessary. Conversely, for children without acute abdominal pain, gastrointestinal endoscopy can be used to determine the location of foreign bodies before deciding whether to choose surgical treatment or not, even if foreign bodies do not move in the continuous dynamic radiography.