Abstract: Objective To investigate the epidemiological and clinical characteristics of human bocavirus (HBoV) in children hospitalized with acute lower respiratory tract infection (ALRTI) in a tertiary children's hospital in Shanghai, providing evidence for diagnosis, treatment, and prevention of HBoV infections. Methods A retrospective study was conducted on 19 537 children hospitalized with ALRTI at Shanghai Children's Hospital from January 2021 to December 2023. Multiplex PCR combined with capillary electrophoresis was used to detect HBoV and 12 other common respiratory viruses /atypical pathogens. The positive rate, demographic characteristics (sex, age), temporal distribution (year, season), as well as the clinical characteristics of severe and non-severe pneumonia were analyzed. Results The overall HBoV-positive rate was 2.57% (503/19 537), with 59.44% (299/503) single infections and 40.56% (204/503) co-infections. The positive rate was significantly higher in boys than in girls (2.78% vs 2.33%, χ²=3.883, P<0.05). The highest infection rate was observed in toddlers, followed by infants (χ²=379.571, P<0.001). The positive rate peaked in 2021 and was lowest in 2023 (χ²=45.494, P<0.001), with epidemics mainly prevalent in summer and autumn. The main clinical symptoms were cough (90.06%, 453/503), fever (75.94%, 382/503), and wheezing (39.96%, 201/503). Among severe pneumonia cases, wheezing was significantly more frequent (P<0.001). Underlying diseases and co-infections had no significant impact on disease severity (P>0.05). Conclusion HBoV was an important pathogen of ALRTI in children, predominantly affecting infants and toddlers, with higher susceptibility in boys and seasonal peaks in autumn and summer. The main clinical manifestations included cough, fever, and wheezing, wheezing was more prevalent in children with severe pneumonia.