The data of pediatric patients who underwent scoliosis surgery from July 2016 to July 2019 were collected retrospectively.The pediatric patients were divided into traditional ventilation group (T group) and lung-protective ventilation group (P group) based on the ventilator settings.Standardized tidal volume(V_T)was obtained by V_T/ideal body weight (IBW). Patients with standardized V_T ≥ 8 ml/kg and without positive end-expiratory pressure (PEEP) were included in group T, and patients with V_T <8 ml/kg and PEEP 4-8 cmH ₂O were included in group P. The propensity score was used to match the baseline information and intraoperative variables in the two groups.A total of 415 pediatric patients accepted screening, and 171 cases were successfully matched, including 92 cases in group T and 79 cases in group P. Compared with group T, the incidence and grade of pulmonary complications were significantly decreased at day 30 after operation, postanesthesia care unit stay time was shortened, body temperature was decreased at 24 h after operation, V_T, standardized V_T and oxygenation index were decreased, P_ETCO₂, PEEP, ventilation frequency and I∶ E were increased (P<0.05), and no significant change was found in IBW, PaCO₂, incidence of postoperative surgical complications and anesthesia-related complications, plasma C-reactive protein concentration and white blood cell count at 24 h after operation, hospitalization time and hospitalization cost in group P (P>0.05). In conclusion, the lung-protective ventilation strategy low V_T combined with PEEP can decrease the risk of postoperation lung complications and is helpful in improving prognosis in the pediatric patients undergoing scoliosis surgery as compared with traditional mechanical ventilation strategy.