ObjectiveTo evaluate the clinical utility of the 2015 International League Against Epilepsy (ILAE) definition of status epilepticus (SE) by comparing the clinical characteristics and treatment outcomes of pediatric SE patients classified according to the revised definition versus the traditional definition. Methods A retrospective cohort study was conducted involving 662 children diagnosed with SE who were admitted to the Children’s Hospital of the Second Affiliated Hospital of Shantou University Medical College between October 1, 2020 and October 31, 2023. Based on the ILAE 2015 definition and the traditional definition of SE (seizure duration >30 min), patients were categorized into a revised-definition group (meeting the new definition but not the traditional definition, n=427) and a traditional-definition group (meeting the traditional definition, n=235). Demographic characteristics, age, prior history of epilepsy, etiology, seizure type, number of antiseizure medications (ASMs) administered, degree of refractoriness, and seizure control outcomes were compared between the two groups. Multivariate logistic regression analysis was performed to identify factors associated with seizure duration exceeding 30 min. Results Of the 662 pediatric patients with SE, 64.5% (427/662) were classified into the revised-definition group and 35.5% (235/662) into the traditional-definition group. In the revised-definition group, most patients had no prior history of epilepsy (95.1%) and predominantly presented with electroclinical syndromes as the underlying etiology (65.8%, 281 cases), among which febrile seizures (FS) accounted for 98.9% (278/281). In this group, 17.4% of seizures resolved spontaneously, 47.7% required only monotherapy, and no cases of refractory status epilepticus (RSE) or super-refractory status epilepticus (SRSE) were observed; the seizure control rate was 100%. In contrast, the traditional-definition group was mainly characterized by cryptogenic/unknown etiology (41.7%) and acute symptomatic etiology (26.8%). The incidences of RSE and SRSE in this group were 43.8% and 8.9%, respectively, and the seizure control rate was 97.9%. Multivariate logistic regression analysis demonstrated that, compared with patients with electroclinical syndromes, those with acute symptomatic etiology had a 9.327-fold increased risk of seizure duration exceeding 30 min [95%CI (5.308, 16.389)]. After adjustment for etiology and other potential confounding factors, each additional ASM administered was associated with a 3.465-fold increase in the risk of seizure duration exceeding 30 min [95%CI (2.695, 4.455)]. Among patients with FS, 9.1% (30/327) experienced spontaneous seizure resolution without pharmacological intervention after hospital admission. Conclusions The 2015 ILAE definition of SE demonstrates good applicability in pediatric clinical practice. Most patients newly encompassed by the revised definition have predominantly benign etiologies and favorable seizure control outcomes. Application of the revised definition facilitates earlier identification and management of SE. However, for children with febrile seizures, close observation rather than immediate initiation of antiseizure medication may be appropriate after convulsions have persisted for more than 5 minutes.