Chronic urticaria is one of the common skin diseases in pediatrics，classified as a skin and mucosal vascular reactive disorder，often recurring and negatively impacting children's physical and mental health.Its pathogenesis，evolution，and prognosis are closely linked to the concept of collateral disease theory in traditional Chinese medicine(TCM).From this perspective，the fundamental mechanism of pediatric chronic urticaria can be summarized as a result of inherent intolerance，where wind pathogens invade the skin，leading to disharmony between the nutrient and defense qi，ultimately damaging the meridians and collaterals.Initial treatment should focus on expelling pathogens and unblocking the meridians，particularly targeting wind pathogens.Additional methods such as dispersing cold，clearing heat，removing toxins，and eliminating dampness can help to soothe meridians，dredge collaterals，and expel internal evils，thereby unblocking collateral vessels.Emphasizing the heart's connection to the exterior is crucial for overall regulation.During the recovery phase，the focus should shift to reinforcing healthy qi and nourishing the collaterals，balancing the principles of strengthening the root and reinforcing healthy qi while addressing pathogenic factors.Throughout both early and later treatment stages，promoting blood circulation and resolving stasis remains a consistent strategy.