Abstract:[Objective] To investigate the value of arthrography used in the diagnosis and treatment of Monteggia fracture in children. [Methods] A total of 46 children with Monteggia fracture were included in this study. All patients underwent elbow arthrography, followed by different treatments based on fracture type and arthrographic results. The clinical and imaging data were evaluated. [Results] Among the 46 patients, 3 underwent manipulation reduction and external fixation with plaster cast, 15 underwent elastic intramedullary nailing, 8 under- went plate and screw fixation, 7 underwent Kirschner wire tension band fixation, 8 underwent mini-Ilizarov external fixator, and 5 underwent unilateral external fixator. All patients had the corresponding treatments performed successfully without serious complications, with the ar- thrography time of (5.83±2.75) min, therapeutic operation time of (46.58±10.45) min. The patients were followed up for (13.06±3.27) months, and resumed full weight-bearing activity in (12.16±1.31) weeks. The clinical fracture healing time was of (11.53±1.06) weeks, with the el- bow flexion-extension range of motion (ROM) of (145.65±6.16)° and the forearm rotation ROM of (163.20±3.62)° at the latest follow up. According to Mayo score, the clinical results were marked as excellent in 43 cases and good in 3 cases, with an excellent/good rate of 100%. Radiographically, the radial axis passed through the center of capitellum with well humeroradial alignment was proved after the treatments, and callus formation on the fracture ends was observed in all patients on images 4 weeks after treatments. [Conclusion] Elbow arthrography does clearly show the congruence of the joint, which accurately reflect the reduction consequence in children with Monteggia fractures.