Objective <p>This study analyzed the frequency and patterns of pediatric neurological disorders and investigated changes in the inpatient disease spectrum following the COVID-19 pandemic.</p> Methods <p>A retrospective analysis was conducted on 2,981 children admitted to the Department of Neurology at the Seventh Medical Center of PLA General Hospital in Beijing, China, between January 2019 and December 2024.</p> Results <p>According to the ICD-10 criteria, the most common diagnoses were “nervous system diseases” (39.74%) and “mental and behavioral disorders” (31.98%). The pandemic led to a significant increase in the proportion of inpatients with mental and behavioral disorders, whereas the proportion of hospitalizations for nervous system diseases among all pediatric neurology admissions decreased. Furthermore, an increase in the number of autism spectrum disorder (ASD) inpatients was observed starting in 2022, with a more notable increase from 2023 to 2024.</p> Conclusion <p>This study provides detailed insights into shifts in the inpatient disease spectrum of pediatric neurology from 2019 to 2024. These findings, which are based on hospitalized patients, highlight changes in healthcare utilization patterns and may inform hospital resource planning. These findings provide a foundation for future research that incorporates outpatient data to understand the pandemic’s impact on pediatric neurological disorders.</p>