Thunderstorm asthma is defined as acute asthma exacerbations occurring during or shortly after thunderstorms, characterized by sudden onset, wide geographic impact, and clustering of cases. Climate change is driving more frequent extreme weather and higher aeroallergen concentrations, making future thunderstorm asthma episodes more frequent and less predictable. In China, the geographic range of pediatric thunderstorm asthma is expanding and its disease burden is underestimated. This paper reviews the literature on thunderstorm asthma in Chinese children, integrates global advances in mechanisms and management, and provides a comprehensive analysis of the epidemiology, pathogenesis, and clinical management of pediatric thunderstorm asthma in China. Regional variation is evident, with historical predominance in northern regions and recent reports from southern cities. Children with seasonal allergic rhinitis constitute a hidden high-risk population; even without an asthma diagnosis, enhanced surveillance and preventive management are warranted. Core components of comprehensive management include graded acute-phase care, pollen concentration monitoring with early warning, and pre-thunderstorm prophylactic medication.