Abstract: Objective: To explore symptoms and symptom clusters during induction chemotherapy of children with malignant tumor. Methods: A total of 238 children with malignant tumor were assessed by the Chinese Version of Memorial Symptom Assessment Scale10-18 (MSAS 10-18), and exploratory factor analysis was used to identify the symptom clusters. Results: The average age of 238 children was (6.40±3.63), and 60.9% were boys. The main symptoms during induction chemotherapy included lack of energy, nervous, lack of appetite, nausea, irritable, and vomiting. Seven symptom clusters were upper gastrointestinal symptom cluster, irritable mood symptom cluster, depressive mood cluster, image impaired symptom cluster, nervous symptom cluster, skin and mucosa symptom cluster, and ingestion and excretion symptom cluster. Conclusion: Children suffered from multiple serious symptoms during induction chemotherapy, and the symptom clusters were various. Health care professionals should assess the symptoms timely, and control the main or key symptoms to relieve symptom distress of patients.