Objective To study the effect of traditional Chinese medicine eczema prescription in the treatment of eczema in children and its effect on clinical symptoms. Methods A total of 58 children with eczema admitted to our hospital from March 2023 to March 2024 were selected as the research objects. They were divided into control group and observation group by random number table method, with 29 children in each group. The control group was treated with conventional western medicine, and the observation group was treated with traditional Chinese medicine eczema prescription on the basis of the control group. The clinical efficacy, clinical symptom score, clinical symptom disappearance time, satisfaction and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the observation group was 96.55%, which was higher than 82.76% in the control group (P <0.05). After treatment, the scores of pruritus, skin lesion area and skin lesion morphology in the two groups were lower than those before treatment, and those in the observation group were lower than the control group (P <0.05). The disappearance time of itching, pain and swelling in the observation group were shorter than those in the control group (P <0.05). The satisfaction score of the observation group after treatment was higher than that of the control group (P <0.05). The incidence of adverse reactions in the observation group was 6.90%, which was lower than 10.34% in the control group, but the difference was not statistically significant (P >0.05). Conclusion On the basis of conventional western medicine treatment, the application of traditional Chinese medicine eczema prescription in the treatment of eczema in children has a good effect. It can improve the total effective rate and satisfaction of treatment, shorten the disappearance time of clinical symptoms, reduce the clinical symptoms of children, and has no significant adverse reactions. It is a safe, effective and feasible combination of traditional Chinese and western medicine.