Objective To evaluate the effect of leuprorelin acetate combined with vitamin D in the treatment of idiopathic central precocious puberty.Methods This study was conducted from January 2021 to December 2023, involving 100 children with idiopathic central precocious puberty admitted to Tianjin Children's Hospital. Using stratified random sampling, patients were divided into an experimental group and a control group, with 50 cases in each group. The control group received leuprolide acetate treatment, while the experimental group was treated with leuprolide acetate combined with vitamin D. The growth status, ovarian volume, follicle diameter, uterine volume, levels of sex hormones [estradiol (E₂), follicle-stimulating hormone (FSH), luteinizing hormone (LH)], serum insulin-like growth factor-1 (IGF-1), and insulin-like growth factor-binding protein-3 (IGFBP-3), and adverse reactions (local pain, mild allergy, erythema, inflammation, vaginal bleeding) were compared between the two groups.Results In the experimental group, the differences in height, growth velocity, and predicted adult height before and after treatment were all greater than those in the control group (P < 0.05). The differences in body mass index and bone age before and after treatment between the experimental and control groups showed no statistical significance (P > 0.05). The differences in ovarian volume, follicle diameter, uterine volume, and levels of E2, FSH, LH, and IGF-1 before and after treatment were all greater in the experimental group compared to the control group (P < 0.05). The difference in the level of IGFBP-3 before and after treatment was lower in the experimental group than in the control group (P < 0.05). The overall incidence of adverse reactions between the two groups showed no significant difference (P > 0.05).Conclusions Leuprolide acetate combined with vitamin D significantly enhances growth and development, controls hormone levels, increases IGF-1 and IGFBP-3 levels, and presents a lower risk of adverse reactions in children with idiopathic central precocious puberty.