Acute diarrhea has a high incidence in children. Pediatric tuina has been widely used in children with acute diarrhea in China. However, there is no guideline on the treatment of tuina for children with acute diarrhea. This guideline was developed following evidence-based principle and the World Health Organization handbook for guideline development. The linked systematic review was conducted following the Cochrane handbook. The quality of evidence and strength of recommendations were evaluated using the GRADE approach. The reporting of guideline followed the RIGHT statement. Seven clinical questions (2 foreground questions and 5 background questions) were identified by literature review and expert consensus. Based on the linked systematic review, comprehensively considering the balance of benefit and harm, the quality of evidence, patient preferences, and other resources, we formulated the recommendations using Delphi expert consensus. We suggested that weak recommendation for tuina combined with western medicine usual care to treat children with acute diarrhea. This guideline can be used by clinicians and nurses in the department of traditional Chinese medicine pediatrics, and department of pediatric tuina, and can also be used as a reference for relevant clinicians of Western medicine, and is also applicable to all institutions that practice tuina treatment.