Background/purpose To date, molecular typing studies of Mycoplasma pneumoniae are limited in Henan. We researched the molecular types of Mycoplasma pneumoniae in pediatric patients in Henan in 2020. Methods M. pneumonia was detected by SAT-MP kit. The domain V of their 23S rRNA were sequenced for detection of macrolide-resistant point mutations. Molecular typing with multiple locus variable-number tandem repeat analysis (MLVA) was done for both macrolide-susceptible and macrolide -resistance M. pneumoniae samples. Results M. pneumoniae was detected in 9.8% (121/1237) respiratory samples in 2020. Among the M. pneumoniae-positive samples, 96% (116/121) had macrolide-resistant genotypes, and all of them were A2063G mutation. 105 macrolide-resistant strains and 4 macrolide-susceptible strains fulfill MLVA typing. MLVA 4-5-7-2 was the most frequent type (60/109, 55%), followed by 3-4-6-2 (49/109, 45%). There was no association between MLVA types and macrolide resistance (p >0.05). Conclusion The percentage of macrolide resistance M. pneumoniae was high (96%) in pediatric patients in 2020 in Henan, and A2063G was the dominant point mutation. MLVA types was independent to macrolide resistance.