Abstract Coronary artery lesions (CAL) represent the most severe complication of Kawasaki disease (KD). This study aims to analyze the relationship between serum Interleukin-6 (IL-6) levels and CAL in KD, and develop a predictive model to provide a scientific basis for clinical risk assessment and personalized treatment of KD. Newly diagnosed children with complete KD admitted to Hainan Women and Children’s Medical Center from January 1, 2022 to December 31, 2024 were enrolled.