Objective To analyze the efficacy of Calcium D combined with recombinant human growth hormone (rhGH) in the treatment of children with idiopathic short stature (ISS) and its effect on serum levels of bone metabolization indexes,insulin-like growth factor-1 (IGF-1),25-hydroxyvitamin D[25-(OH)D].Methods Totally 90 children with ISS (ISS group) in Zhengzhou Yihe Hospital Affiliated to Henan University from January 2015 to June 2017 were enrolled in this study,and were randomly divided into observation group and control group,with 45 cases in each group. The control group was treated with rhGH,the observation group was treated with rhGH and Calcium D. And 45 children taking physical examination matched by sex and age were selected as normal group. The height (Ht),bone age (BA),growth rate (GV),height standard deviation score (HtSDS),BA-to-chronological age (BA/CA) and serum levels of bone metabolization indexes[osteocalcin (OC),type I procollagen amino terminal prolongation peptide (P1NP)],IGF-1 and 25-(OH)D of observation group and control group were observed before treatment,6 and 12 months after treatment. The indexes were compared with normal group. Results The BA,Ht,GV,HtSDS,BA/CA and serum levels of OC,PICP,IGF-1,25-(OH)D in the ISS group were significantly lower than those in normal group (P<0.05). After 6 and 12 months of treatment,the BA,Ht,GV,HtSDS,BA/CA and serum levels of OC,PICP,IGF-1,25-(OH)D in the observation group significantly increased (P<0.05). However,the 25-(OH)D in control group did not change significantly (P>0.05). Moreover,the Ht,GV,HtSDS,HtSDS and serum levels of OC,PICP,IGF-1,25-(OH)D in the observation group were significantly higher than those in control group (P<0.05). Conclusions There is abnormal bone metabolism and low level of IGF-1 and 25-(OH)D in children with ISS. Calcium D adjuvant therapy can improve bone metabolization and increase serum levels of IGF-1 and 25-(OH)D,thereby improving growth development