Objective　To explore the hospitalization characteristics and follow-up outcomes of children with severe tic disorders（TD）， providing a basis for clinical diagnosis and management. Methods　A retrospective study was conducted on 46 children with severe TD who were admitted to Wuhan Children’s Hospital，affiliated to Tongji Medical College，Huazhong University of Science and Technology，from January 2021 to January 2025. Clinical data were analyzed，including clinical features on admission，treatment regimens during hospitalization，and follow-up outcomes（January 2021 to January 2025），and characteristics were summarized. Results　Among the 46 children with severe TD，43 were male（93.48%），with an average age on admission being（10.84±2.79） years，and a median disease duration being 23 months. The main symptoms were vocal tics in the throat（27 cases，58.70%） and complex motor tics involving the whole body（20 cases，43.48%）. Eight children had to suspend schooling due to severe tic symptoms. The comorbidity rate was 58.70%（27/46），with emotional disorders being the most common（23 cases，50.00%）. Medications primarily included sulpiride（32 cases，69.57%） and aripiprazole（24 cases， 52.17%），with no statistically significant difference in drug dosage before and after admission（P>0.05）. Non-pharmacological treatments included transcranial magnetic stimulation（19 cases，41.30%） and acupuncture（13 cases，28.26%）. Seven cases showed elevated serum cytokines（mainly IL-6 and TNF-α）. Follow-up showed that at 3 months，53.33%（8/15） of children had significant symptom improvement，while 33.33%（5/15） still had severe functional impairment. At the last follow-up，93.75%（30/32） of children had no severe functional impairment，but 2 cases still had severe functional impairment due to tic symptoms. Two cases showed gradual reduction of tic symptoms during follow-up but developed some psychiatric and emotional problems. Conclusion　Severe TD requires individualized treatment and may benefit from a combination of pharmacological and non-pharmacological approaches. Attention should be given to comorbidities and long-term psychiatric symptom risks. Immune factors may be involved in disease progression but require further verification.

severe tic disorders, Tourette syndrome, emotional disorders