Objective To observe the therapeutic effect of recombinant human growth hormone (rhGH) combined with psychological intervention on children with idiopathic short stature and to investigate its mechanism.Methods A total of 90 children with idiopathic short stature in our hospital from January 2016 to January 2019 were randomly divided into observation group and control group, with 45 cases in each group. All the children were given conventional therapies, based on which the control group was treated with rhGH alone while the observation group was treated with combined rhGH and psychological intervention. Before and after the treatment, the psychological and emotional states of the two groups of children were evaluated, the rhGH treatment compliance was investigated, and the growth indicators [height, height standard deviation score (Ht SDS), growth velocity (GV), predicted adult height (PAH)], bone metabolic indicators [serum osteocalcin (OC), 25-hydroxyvitamin D [25(OH)D]) and insulin growth factor-1 (IGF-1) were detected.Results The scores of Hamilton Anxiety Scale (HAMA) and emotional stability of children differed between the two groups and altered at different time points with distinct change trends (P < 0.05). There was no difference in rhGH treatment compliance between the two groups at 3 and 6 months after the treatment (P > 0.05). However, at 9 and 12 months following the treatment, rhGH treatment compliance was higher in the observation group (P < 0.05). The differences of height, Ht SDS, GV and PAH before and after treatment were greater in the observation group than those in the control group (P < 0.05). Besides, the differences of OC, 25(OH)D and IGF-1 before and after treatment were also greater in the observation group (P < 0.05).Conclusions On the basis of rhGH treatment, combined with psychological intervention can effectively enhance the clinical efficacy of idiopathic short stature in children. The mechanism may be related to the improvement in children's mental health, rhGH treatment compliance, bone metabolism, and IGF-1 level.