Abstract: Rheumatic and immunologic diseases in children may involve multiple genes and interactions between genetic and environmental factors. There are no validated biomarkers that are predictive of treatment response. Treatment is largely based on symptoms, treatment guidelines, physician experience, and medicine accessibility. The application of precision medicine in pediatric rheumatic and immunologic diseases is in its infancy. This article focuses on the progress of precision medicine in juvenile idiopathic arthritis and pediatric systemic lupus erythematosus, in order to build a precision diagnosis and treatment system for pediatric rheumatic and immunologic diseases, and improve children's quality of life.