In addition to neuropsychiatric symptoms such as irritability, crying, nocturnal screaming, excessive sweating and occipital baldness, vitamin D deficiency rickets mainly causes skeletal changes, such as O-leg and X-leg, chicken breast and square skull, but it generally does not cause organic damage to intelligence and organs. In modern society, the requirements of eugenics, early detection and early prevention of rickets to reduce these effects appear more and more urgent. Whose child does not want to grow strong, whose child does not want to stand tall and handsome, whose child does not want to have straight and long legs. We emphasize early diagnosis of rickets while preventing overdiagnosis to prevent abuse of vitamin D and calcium supplements. X-ray examination and 25-(OH)D3 measurement are the gold standard for the diagnosis of rickets. 25-(OH)D3 is the main form of vitamin D in the human blood circulation and is the intermediate product of its metabolism, with the highest concentration, most stable and longest half-life in the blood. Clinically, typical vitamin D deficiency rickets can be divided into the initial phase, the acute phase, the recovery phase, and the post-acute phase. In rickets, the radical phase can be seen on the ulna, 3rd, 4th, 5th metacarpal bones, and the front of the rib cage on X-ray. In children in the recovery phase, except for the widening of the ulnar and radial epiphysis which can continue to exist, the edges of the epiphysis all become shiny and neat, the temporary calcification zone reappears, and the anterior end of the metacarpal bone becomes shiny and neat and clear. These X-ray changes can be used as a clear imaging basis to evaluate the effectiveness after treatment. It has been reported that the occurrence of rickets in children is related to the children’s history of previous diseases, and there is a correlation between the occurrence of rickets and children’s susceptibility to upper respiratory tract infections, diarrhea, and anemia, especially those who frequently suffer from upper respiratory tract infections are 2.7 times more likely to develop rickets than those who do not frequently suffer from upper respiratory tract infections. Accurate diagnosis of vitamin D deficiency rickets is the key to the implementation of intervention. Wrist radiographs or chest radiographs of children with respiratory diseases can provide clear X-ray diagnostic clues for the diagnosis and staging of vitamin D deficiency rickets as well as the evaluation of treatment effects. X-ray examination should be a simple, convenient and universal means to accurately diagnose rickets and assess the effectiveness of treatment.