INTRODUCTION: Human respiratory syncytial virus (HRSV) is the predominant respiratory pathogen causing acute respiratory tract infection (ARTI). Globally, HRSV infection represents the leading cause of acute respiratory morbidity and hospitalization in children under 2 years of age. HRSV infection continues to pose a significant public health challenge worldwide. Through epidemiological surveillance of HRSV in children with ARTI, we can elucidate its incidence patterns and epidemic characteristics to inform evidence-based prevention and control strategies. METHODS: We collected upper and lower respiratory tract specimens and clinical data from children under 14 years of age with ARTI. HRSV was detected using Real-time Polymerase Chain Reaction to analyze its incidence and epidemic characteristics. RESULTS: Among 1,440 specimens, the overall HRSV detection rate was 7.8% (HRSVA and HRSVB detection rates were 4.0% and 3.8%, respectively). Detection rates peaked in spring (12.2%), followed by winter (10.3%), with the lowest rates in autumn (2.8%) ( CONCLUSIONS: HRSV exhibited consistent circulation among children with ARTI in the Shijiazhuang area from 2021 to 2023, characterized by winter and spring outbreaks and alternating predominance of subtypes A and B. Infections predominantly affected children under 5 years of age.