【Abstract】 Objective To analyze the monitoring situation of suspected adverse events following immunization (AEFI) in Pingdingshan City in 2019, evaluate the safety of vaccination in Pingdingshan City and provide guidance for follow-up AEFI monitoring. Methods The vaccination data and AEFI data of Pingdingshan City in 2019 were collected, and the distribution characteristics of AEFI in Pingdingshan City were calculated by descriptive epidemiology. Results In 2019, a total of 791 AEFI cases were reported in 10 counties (districts) of Pingdingshan City, of which 749 cases (94.69%) were general reactions. The top 3 vaccines were DTaP (acellular) vaccine, MMR vaccine and JE vaccine (attenuated). There were 40 cases (5.06%) abnormal reaction and 2 cases(0.25%) of coincidental diseases. Fever/redness/ swelling/induration are common in general reactions, and allergic reactions are common in abnormal reactions. The majority of AEFI cases were children under 2 years old with a total of 550 cases(69.53%). Severe abnormal reactions include febrile convulsion, syncope, thrombocytopenic purpura, epilepsy, BCG lymphadenitis. Conclusion In 2019, the AEFI cases in Pingdingshan City were mainly general reactions, and the AEFI cases were mainly concentrated in Lushan County, Ye County and Weidong District. Vaccines have high safety, and the sensitivity of the AEFI monitoring system should be improved.