【Objective】To comprehensively compare the feasibility of three different treatment strategies consisting of low-dose chemotherapy（LDC），surgery and surgery with adjuvant low-dose chemotherapy（SLDC）for children with solitary bone lesions of eosinophilic granuloma（SBL-EG）.【Methods】We retrospectively reviewed the records of 149 pediatric patients with SBL-EG at our institutions from 2002 to 2014. Our study included 86 patients who received LDC，33 patients who received surgery and 30 patients who received SLDC. The duration of hospital stay，time to symptom relief，recovery time，cost，complications and relapse-free sur? vival（RFS）of each strategy were analyzed.【Results】Hospital stay，time to symptom relief，recovery time and cost in the LDC group were significantly shorter or less than those in the surgery or SLDC group（P < 0.05）. No statistically significant differences were observed in the above-mentioned factors between the surgery and SLDC groups（P > 0.05）. Chemotherapy-related adverse events in the LDC and SLDC groups included nausea（8.62%），aminotransferase elevation（7.76%），slight hair loss（4.31%）， immunity decline（21.55%），growth retardation（10.34%）and moon face（7.76%）. LDC and SLDC treatment resulted in a significantly longer RFS（147 months and 126 months，respectively）than surgery alone（114 months）（P = 0.005 and 0.019， respectively）. However，there was no statistically significant difference in RFS between the LDC and SLDC groups（P = 0.732）. 【Conclusions】Compared with surgery or SLDC，LDC appears to promote more rapid recovery，less invasion，increase safety and eco?nomic treatment strategy for pediatric patients with SBL-EG.