Objective To assess the motor developmental outcome at 4 years old children conceived by intracytoplasmic sperm injection (ICSI) and to compare with children conceived naturally. Methods Children enrolled were conceived by ICSI from Jan.2009,through to the end of Dec.2009 in the State key Laboratory of Reproductive Medicine Department of Nanjing Maternity and Child Health Care Hospital.18 ICSI alive single born underwent movement assessments and 36 control subjects as normal control (NC) were matched with respect to age,gender,and birth number.The children were excluded if their gestational weeks less than 32 weeks,birth weight less than 1 500 g,with fetal distress or birth asphyxia history.Children's motor development was assessed with the Movement Assessment Battery of Children (M-ABC) and children sensory integration scale,respectively. Results Physical development:the birth length [ICSI:(48.72±2.52)cm,NC:(50.33±1.24)cm],and birth weight [ICSI:(3.04±0.68)kg,NC:(3.50±0.42)kg] of ICSI group were significantly lower than the control group (P<0.05);at 4 years old,no significant differences were found in the height,weight or head circumference of the two groups(all P>0.05).Motor development:there were no differences in terms of flexibility,hand-eye coordination or total score; However,ICSI group was significantly lower than the control group in balance (ICSI:8.44±1.72,NC:10.92±3.18,P<0.05).Sensory integration capabilities:There were no differences in balance and vestibular double differentiation of the brain,tactile defensiveness,developmental dyspraxia,visual-spatial and shape sensory,the center of gravity or overall evaluation. Conclusion By refining assessment content,expanding the sample size and extending follow-up time,we can provide more powerful evidence for judgment of the long-term developmental outcomes of assisted reproductive offspring.