ObjectiveTo summarize the image features of dermatoscopy and reflectance confocal microscopy (RCM) in children with scabies, and to explore the clinical significance in the diagnosis of children scabies.MethodsA retrospective analysis was conducted on 102 children scabies diagnosed clinically in the dermatology outpatient department of Tianjin Children's Hospital from April 2018 to June 2022. All children were examined by dermatoscopy and RCM, and images were collected.Results102 patients, 92 patients (90.2%) showed characteristic dermoscopic manifestations: white tunnels and small brown or dark brown triangular structures at their ends. 91 patients (89.2%) showed characteristic reflectance confocal microscopic manifestations: tunnels, scabies mites, feces, and eggs in the epidermal layer. All patients showed different degrees of non‐specific manifestations of dermoscopy and RCM.ConclusionChildren scabies have typical dermatoscopic and reflectance confocal microscopic characteristics, and dermatoscopy and RCM are effective non‐invasive diagnostic methods with high clinical application value in the diagnosis and differential diagnosis of children scabies.