Objective To preliminarily assess the efficacy and safety of telitacicept in pediatric IgA nephropathy (IgAN). Methods Clinical data of 11 children with IgAN who received telitacicept in the Department of Pediatrics, Provincial Hospital Affiliated to Fuzhou University, from January 2024 to October 2025 were retrospectively collected. Parameters compared before and after treatment included 24-hour urinary protein, serum albumin, immunoglobulins (IgG, IgA, IgM), peripheral blood CD19⁺ cells, estimated glomerular filtration rate (eGFR), and glucocorticoid dosage. Adverse events were recorded. Results At 4, 12, 24, 36, and 48 weeks after treatment, 24-hour urinary protein was significantly lower than baseline (all P<0.05), with the greatest reduction at 12 weeks (P<0.001). Serum albumin increased compared with baseline, reaching statistical significance at 12, 24, and 36 weeks (all P<0.05). IgG and IgA levels decreased significantly at all time points (all P<0.05), and IgM showed an overall downward trend (P<0.05). CD19⁺ cell counts showed no significant change (P>0.05). Glucocorticoid dosage was significantly reduced (P<0.05), while eGFR showed no significant change (P>0.05). A total of 6 adverse event episodes were recorded, predominantly mild respiratory infections; no serious adverse events occurred. Conclusions Telitacicept can effectively reduce proteinuria in children with IgAN and demonstrates an overall favorable safety profile.