Abstract: Objective To compare the difference of blood pressure criteria for children among China, the United States and Europe and the difference in blood pressure measurement. Methods The latest blood pressure criteria for children and adolescents in China, the normal blood pressure standard of the United States, and Europe were used to calculate the differences of blood pressure criteria for the same age, gender, and height by difference analysis and construction of generalized additive model curves for blood pressure change with height. Based on three blood pressure measurements of 45 314 Chinese and 15 279 American children and adolescents, the differences in blood pressure measurements were calculated by repeated-measurement analysis of variance, and which were compared with the differences between criterias. Results More than 60% of the differences in blood pressure standard among China, the United States and Europe were distributed in the range of-3 to 3 mmHg. But in individual age groups, there was a significant difference in standard values: in comparison between standards of Chinese and the United States, the difference of P₉₅ cutoff point for systolic blood pressure was 10 mmHg at the age of 13, and the difference of P₉₅ cutoff point for diastolic blood pressure was 5 mmHg at the age of 3; in comparison between standards of Chinese and European, the difference of P₉₅ cutoff point for systolic blood pressure was 9 mmHg, and that for diastolic blood pressure was 6 mmHg at the age of 16. The analysis of repeated blood pressure data showed that the maximum difference in systolic blood pressure measurement was 3.7 and 4.1 mmHg, and the maximum difference in diastolic blood pressure measurement was 2.0 and 2.1 mmHg for Chinese boys and girls, respectively. while the difference between the three measurements in American boys and girls was within1 mmHg. Conclusion The differences of blood pressure standards between countries are smaller than the differences between multiple measurements of blood pressure, and accurate and repeated measurements of blood pressure are more important for evaluating blood pressure status than the choice of blood pressure standards.