Cognitive behavioral therapy (CBT) has been widely used in pediatric cancer patients to promote psychological adjustment (PA). Considering the diversity of region and culture in China, its effect in Chinese population is not well defined. Therefore, our study is to explore the effect of CBT on improving PA in Chinese pediatric cancer patients receiving chemotherapy.One hundred four Chinese pediatric cancer patients receiving chemotherapy were divided into CBT group and control group randomly and equally. The resilience and negative mood were applied to evaluate the ability of psychological adjustment (PA). The Conner-Davidson Resilience Scale (CD-RISC) and depression anxiety stress scale (DASS) were employed to measure resilience and negative mood before and after intervention. The SPSS 22.0 software was used to analyze data.Prior to the intervention, the ability of psychological adjustment between 2 groups showed no significant difference (P > .05 for all). After intervention, the total CD-RISC score was significantly higher (56.09 ± 7.29 vs 44.75 ± 5.40), whereas the scores of depression (4.57 ± 2.94 vs 7.25 ± 4.25), anxiety (5.83 ± 3.07 vs 8.66 ± 4.92), stress (7.51 ± 4.33 vs 11.17 ± 4.25) were obviously lower in CBT group than those in the control group (P < .05 for all). Moreover, the decline of negative mood score in Yolk sac tumor children was the most evident in CBT group. While the resilience changes of cancer children in stage III was most obvious.CBT can effectively help Chinese pediatric cancer patients modify distorted cognition to have a positive attitude towards cancer and chemotherapy. This treatment enhances resilience and relieves negative mood, which results in good psychological adjustment ability, especially in Yolk sac tumor and stage III. It has a beneficial effect on better treatment cooperation and high long-term quality of life.