Since syncope is a common condition and some patients have a high risk of sudden death, we developed a simple and practical syncope diagnostic procedure that meets the characteristics of children in China according to the existing syncope diagnosis guidelines and the current situation of research in China, and conducted a multicenter application study with many hospitals in China. The efficiency of the procedure was found to be 81.1%, and the health economics evaluation of the new diagnostic procedure showed that the average cost of consultation was lower than that of the traditional diagnostic procedure, and the day of diagnosis was significantly shorter than that of the traditional diagnostic procedure, and the average hospital stay was also significantly shorter. And based on the above findings, in 2009, the Cardiovascular Group of the Pediatric Society of the Chinese Medical Association and the Editorial Board of the Chinese Journal of Pediatrics issued guidelines for the diagnosis of syncope in children in China. 1. First, determine whether the child is syncope. This question is crucial because in clinical practice many children with syncope are misdiagnosed as having epilepsy. According to one of our studies, certain features often suggest that the child has a syncopal seizure rather than a convulsive seizure. In addition, loss of consciousness in special situations such as urination, defecation, coughing, etc., often suggests a syncopal episode. If the loss of consciousness is longer than 5 min, the child has disorientation after the attack, slow recovery of consciousness, and the attack is accompanied by limb movements or changes in muscle tone, it often suggests a convulsive attack rather than a syncopal attack, especially if the limb movements are rhythmic movements, which often suggests a convulsive attack. 2. Detailed examination. According to the recommendations of the European Society of Cardiology, the initial evaluation of a child with syncope includes a detailed history, careful physical examination, prone blood pressure measurement, and electrocardiogram, and the child is classified as having a definite diagnosis, a diagnosis that is suggestive, or unexplained syncope. For detailed medical history, please refer to: “Main contents of medical history of children with syncope”. 3. In children with unexplained syncope, abnormalities in cardiac structures and abnormal electrocardiograms can determine whether the child needs further investigation. There is no consensus on whether all children with unexplained syncope should have an echocardiogram, but any child with an indication of cardiac disease should be further investigated. In children with cardiac structure and ECG abnormalities, the most common cause of syncope is arrhythmia. Therefore, 24-hour ECG monitoring and cardiac electrophysiology are the most common methods of further investigation. Cardiac electrophysiological examinations are performed to evaluate sinus node function and induce supraventricular or ventricular arrhythmias. 4. In children without structural cardiac abnormalities and with a normal ECG as well, vasovagal syncope is the most common cause. The upright tilt test is the most important method for diagnosis in this group of children. According to our study, the application of upright tilt test and drug-induced upright tilt test can diagnose about 80% of these children. The upright tilt test can further diagnose syncope due to upright hypotension and postural tachycardia syndrome. However, psychiatric counseling should be recommended for children with frequent syncopal episodes and significant psychiatric symptoms, such as significant depression, stress, and anxiety, even if the upright tilt test is positive. 5. Observation. In children with no structural cardiac abnormalities and normal ECG, if the episodes of syncope are very few or only 1 episode, since such children are generally recommended not to need treatment, the upright tilt test can be given without an upright tilt test but with observation and further evaluation if necessary. 6. After the above systematic clinical evaluation and application of diagnostic methods it is generally possible to establish a diagnosis for children with syncope. If the diagnosis is still not clear, the entire evaluation should be re-examined, especially by re-interrogating the child’s medical history and the information provided by the child’s witnesses during the seizure in detail, and by re-examining the physical examination for diagnosis.