Objective To analyze the clinical features and evaluate the local treatment effect among 56 neonatal cases with strong lymph reactions caused by Bacille Calmette Guerin (BCG) vaccination. Methods A total of 56 neonatal cases with strong lymph node reactions caused by BCG vaccination were collected from tuberculosis clinic from January 2010 to May 2014, whose clinical features were analyzed.The treatment effects were evaluated after given hot pack, needle aspiration, debridement and antituberculous drugs according to their different lesion types. Results 1) Lesion typeThe lesions of the 56 cases were classified into node without liquefaction (7 cases), liquefaction (20 cases), abscess rupture (23 cases), unhealed after surgery (6 cases).2)Treatment effectsamong 7 cases without liquefaction, 5 cases' lymph node shrunk and 2 cases' lesion liquefied after hot pack treatment;Liquefaction lesions of 22 (20+2) cases were turned into abscess rupture after treatments of local aspiration and nodule injection of isoniazid (INH) combined with hot pack; abscess rupture lesions of 45 (23+22) cases were healed after given debridement, wound drainage with INH, pack with rifampicin (RFP); 6 surgery unhealed cases were healed after treatments with debridement, wound drainage with INH and RFP pack. Conclusion There are multiple clinical features of strong lymph node reaction caused by BCG vaccination among neonatal cases, and the local treatments given in this study would get high cure rate.