Objective To investigate the clinical effect of oral acyclovir tablets in the treatment of Epstein-Barr virus infection in children. Methods A total of 100 children with Epstein-Barr virus infection who were hospitalized in our hospital from July 2019 to June 2022 were selected as research objects. 100 children were divided into groups according to random number table method, with 50 cases in each group. The control group was not treated with acyclovir, while the study group was treated with acyclovir tablets. The total effective rate, symptom remission time, length of hospital stay and incidence of adverse reactions were compared between the two groups. Symptom scores, serum inflammatory factor indexes and quality of life scores before and after treatment were compared between the two groups. Results The total effective rate of the study group was higher than that of the control group, the difference was statistically significant (P<0.05). Compared with the control group, the remission time of fever, sore throat and lymph node enlargement was shorter in the study group, and the length of hospitalization was also shorter in the study group, the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). After treatment, symptom score and serum inflammatory factor indexes were lower in the study group, and the difference was statistically significant (P<0.05). After treatment, the quality of life scores of both groups were higher than before treatment, and the study group was higher, the difference was statistically significant (P<0.05). Conclusion In children infected with Epstein-Barr virus, the oral administration of acyclovir tablets has good efficacy, which can not only accelerate the relief of symptoms, reduce inflammation, improve the quality of life, but also does not increase the adverse drug reactions, with good safety.