OBJECTIVE To explore the possibility of early diagnosis of Kawasaki disease (KD) complicated by coronary artery lesions (CAL). METHODS Medical records of 84 children with KD (2 months to 8 years of age) were reviewed retrospectively. Diagnosis of KD was based on current diagnostic criteria of KD. Laboratory examinations were performed for white blood cells (WBC), hemoglobin (HB), platelet counts (Plt), and C-reactive protein (CRP), along with electrocardiography (ECG) and echocardiography within 7 days after the onset of the disease. The Pearson correlation and multivariate analysis (logistic) were used for statistical analysis. RESULTS During the first 7 days, clinical manifestations of the patients included fever (100%), conjunctivitis (71.46%), skin rash (66.7%), extremity change (54%), oral mucosa change (80%), and cervical lymphadenopathy (25%). Laboratory examinations revealed elevated WBC, CRP, and ECG (P<0.05, 0.05,0.01, respectively) in patients with CAL. Multivariate logistic regression analysis indicated that ECG positivity (P<0.01) and WBC increases (P<0.01) were independently correlated with CALs in acute KD. CONCLUSIONS CRP (+), ECG (+), WBC count increase during the acute phase of KD are important indicators to predict CAL caused by KD.