Objective To investigate the safety and effectiveness of different intravenous anesthesia methods for pediatric ERCP. Methods Data of 45 children undergoing ERCP at the Affiliated Hangzhou Hospital of Nanjing Medical University from August 2013 to July 2016， including intravenous anesthesia，the procedure of ERCP， adverse reactions and the waking time were retrospectively studied. Results A total of 45 patients in two groups under intravenous anesthesia successfully underwent ERCP. Seventeen patients （37.8％） whose body weights were over 20 kg and the duration of surgery was predicted less than 30 minutes received deep sedation without airway intubation. Twenty-eight patients （62.2％） with an initial weight of less than 20 kg and the duration of surgery was predicted more than 30 minutes received general anesthesia with airway intubation. In patients with deep sedation， the mean time of waking was 7.2±6.3 minutes， body movement reaction occurred in 1 case （5.9％） and with transient decreasing of pulse blood oxygen （beyond 95％） occurred in 2 cases （11.8％）. In patients receiving endotracheal anesthesia with intubation， the mean waking time was 10.5±8.7 minutes without adverse reactions associated with anesthesia. Conclusion Both deep sedation and general anesthesia with airway intubation are safe for pediatric ERCP. However， general anesthesia with airway intubation is an ideal method ensuring the airway safety and oxygen supply for children less than 20 kg undergoing first-time ERCP or the duration of surgery lasting over 30 minutes.