Objective To explore the effects of vagus nerve stimulation by electroacupuncture on clinical efficacy and expression level of inflammatory factors in adolescent depression patients. Methods A total of 78 adolescent depression patients were randomly divided into experimental（ vagus nerve stimulation by electroacupuncture + Sertraline， n=40） and control group（ Sertraline， n=38）. All the patients were evaluated at the baseline and 4 weeks after treatment. The Positive and Negative Syndrome Scale（ PANSS） and Hamilton Depression Scale（ HAMD-17） were applied to evaluate efficacy. ELISA was used to detect the expression level of IL-1α，TNF-α，IL-6，IL-2. Results The effective rate of the experimental group was 80.0%（ 32/40）， and that of the control group was 57.9%（ 22/38）. The difference was statistically significant（ χ2=4.470，P=0.034）. The negative factor， the general psychopathology and the total score of PANSS and the total score of HAMD-17 of the 2 groups all decreased than before treatment（ P＜0.05）. The general psychopathology and the total score of PANSS and the total score of HAMD-17 of the experimental group were lower than those of the control group （P＜ 0.05）. IL-1α，TNF-α，IL-6， IL-2 of the experimental group decreased than before the treatment and those of the control group after treatment（ P＜ 0.05）. Conclusions Vagus nerve stimulation by electroacupuncture can improve depressive symptoms in adolescents， possibly by reducing the level of inflammatory factors.