Stroke is a rare complication of Mycoplasma pneumoniae infection although recent studies suggest that infection may be a risk factor of acute ischemic stroke. We report a 5-year-old girl who had a stroke 10 days after M. pneumoniae infection. This is the first case of documented middle cerebral artery occlusion after Mycoplasma infection in children. In this article, we review other published reports on this topic and discuss the possible underlying mechanisms of the middle cerebral artery occlusion.