Background: Spinal injury in children usually occurs in the cervical spine region. Anterior fixation of lower cervical spine has been applied in the treatment of pediatric cervical spine injury and disease due to its stable and firm mechanical properties. This study performed finite element analysis and comparison of 4 different anterior cervical internal fixation systems for children, and explored more stable methods of anterior cervical internal fixation in children. Methods: A finite element model of 6-year-old children with lower cervical spine C4/5 discectomy was established, and the self-designed lower cervical spine anterior locking internal fixation system ACBLP and the children’s anterior cervical internal fixation system ACOP, ACVLP, ACSLP plate screws were fixed and loaded on the model. 27.42N•m torque load was applied to each internal fixation model under 6 working conditions of anteflexion, backward flexion, left flexion, right flexion, left rotation and right rotation, to simulate the movement of the cervical spine. The activity and stress distribution cloud diagram of each finite element model was obtained. Results: In the four internal fixation models of ACOP, ACVLP, ACSLP, and ACBLP, the mobility of C4/5 segment basically showed a decreasing relationship, and the mobility of adjacent segments increased significantly. In the Mises stress cloud diagram of the cervical spine of the four models, the vertebral body and accessories of the ACBLP model born the least stress, followed by ACSLP; The steel plate and screws in the ACVLP internal fixation model were the most stressed; The stress of the internal fixation system (plate/screw) in all models increased in the order of ACBLP, ACSLP, ACVLP, and ACOP.Conclusions: ACBLP internal fixation system had obvious advantages in anterior internal fixation of lower cervical spine in children, C4/5 had the smallest degree of movement, relative displacement was minimal, the stress on the pedicle was the least while the stress on the plate screw was relatively the smallest.