Objective: To analyze the epidemiological and infection characteristics of childhood influenza A virus infections in Hebei, China, from 2020 to 2024, and to provide a basis for influenza prevention and control among children.Methods: A retrospective analysis was conducted on epidemiological and clinical data of children with influenza A virus infection who were hospitalized in Hebei Province from January 2020 to December 2024. Clinical specimens were analyzed using nucleic acid extraction reagents with automatic extraction on the Smart LabAssist-32 nucleic acid extractor. A 13-pathogen multiplex PCR detection kit combined with the GeXP multiplex gene expression analysis system was used for testing.Results: A total of 298,810 specimens from children with upper and lower respiratory tract infections were collected. Among which 60,928 specimens were positive for influenza A virus (detection rate: 20.39%). The infection rate was highest in 2024 (23.03%) and lowest in 2020 (13.57%). The annual positive detection rates of influenza A virus in Hebei from 2020 to 2024 were 13.57%, 16.97%, 19.95%, 20.41%, and 23.03%, respectively, with statistically significant differences (P?