The clinical data of one case of Kawasaki disease complicated with parapharyngeal space involvement as the main manifestation hospitalized in our department in November 2019 were retrospectively analyzed，and the clinical manifestations and imaging characteristics of Kawasaki disease complicated with head and neck symptoms were analyzed by reviewing and summarizing the previous literatures.

The male 3-year old patient had fever for 8 d，and was hospitalized due to neck movement limitation and torticula for 2 d. The physical examination results showed that there were red macular papules on the trunk， swollen lymph nodes on the neck， conjunctival hyperemia， red lips， waxberry tongue， and hard swelling of hands and feet. The total number of white blood cells and C-reactive protein （CRP） in blood routine examination were significantly increased. On the 20th day of the course of disease， typical membranous desquamation appeared in the extremities of the patient， which was clearly diagnosed as Kawasaki disease.The children had neck movement limitation and torticollis on admission，and the imaging results suggested a mass in the right parapharyngeal space of nasopharynx and oropharynx. The symptomatic treatment of the patient was ineffective after given antibiotics and antipyretic. After treatment with gamma globulin and aspirin， the neck movement limitation and torticula of the patient disappeared， the symptoms and signs of Kawasaki disease were improved， and the inflammatory indicators of laboratory examination were gradually returned to normal， and the neck MRI results showed that the inflammatory range of parapharyngeal space was significantly smaller than before.

The abnormal manifestations of head and neck can be presented as early manifestations of Kawasaki disease， which is easily misdiagnosed as suppurative lymphadenitis or parapharyngeal and retropharyngeal suppurative infection. Kawasaki disease complicated with parapharyngeal space or retropharyngeal space inflammation should be correctly diagnosed and treated as soon as possible to avoid the cardiovascular system damage and unnecessary surgical treatment.