Objective To observe the changes of serum IL-35 and Th2 cytokines in children with bronchiolitis and to explore their significance. Methods Sixty-eight hospitalized children with bronchiolitis (observation group)and 20 non-infected children in the same period (control group)were selected. According to the severity of the disease, children with bronchiolitis were divided into the mild group and moderate-severe group. Serum IL-35, IL-4, IL-10, IL-13 and IL33 were detected by ELISA. The levels of serum cytokines were compared between the observation group and the control group, the mild group and the moderate-severe group. Spearman correlation was used to analyze the correlation between serum cytokines. Multiple linear regression was used to analyze the influencing factors for the severity of bronchiolitis. ROC was used to analyze the diagnostic efficacy of the above serum cytokines in the moderate-severe bronchiolitis. Results Compared with the control group, the levels of serum IL-35, IL-10 and IL-33 in the observation group were lower, and the levels of IL-4 and IL-13 were higher (all P<0. 05). Compared with the mild group, the levels of serum IL-35, IL10 and IL-33 in the moderate-severe group were lower, and the levels of IL-4 and IL-13 were higher (all P<0. 05). The level of serum IL-35 in the observation group was positively correlated with IL-10 (P<0. 05), and was negatively correlated with IL-4 (P<0. 05). Serum IL-4, IL-10, IL-13 and IL-33 in the observation group were the influencing factors for the se‐ verity of bronchiolitis (all P<0. 05). When the cut-off value was 10. 53 pg/mL, the area under the curve of serum IL-35 level in diagnosing moderate-severe bronchiolitis was 0. 760, and the sensitivity and specificity were 70. 6% and 70. 6%, respectively. When the cut-off value was 7. 3 pg/mL, the area under the curve of serum IL-4 level in diagnosing moderatesevere bronchiolitis was 0. 827, and the sensitivity and specificity were 82. 4% and 73. 5%, respectively. When the cutoff value was 115. 38 pg/mL, the area under the curve of serum IL-10 level in diagnosing moderate-severe bronchiolitis was 0. 712, and the sensitivity and specificity were 44. 1% and 97. 1%, respectively. When the cut-off value was 643 pg/mL, the area under the curve of serum IL-13 level in diagnosing moderate-severe bronchiolitis was 0. 739, and the sensitivity and specificity were 97. 1% and 41. 2%, respectively. When the cut-off value was 22. 61 pg/mL, the area under the curve of serum IL-33 level in diagnosing moderate-severe bronchiolitis was 0. 635, and the sensitivity and specificity were 26. 5% and 100. 0%, respectively. Conclusions The levels of serum IL-35, IL-10 and IL-33 in children with bronchiolitis decrease, while the levels of IL-4 and IL-13 increase, and the levels of the above indices of the moderate-severe children are more obvious than those of mild children. The level of serum IL-35 is positively correlated with the level of IL10 and is negatively correlated with the level of IL-4. Th2 cytokines are the influencing factors for the severity of bronchiolitis. IL-35 and Th2 cytokines can be used to help judge the severity of bronchiolitis. [ABSTRACT FROM AUTHOR]