Objective: In China, understanding and research on emm cluster and emm pattern typing of GAS remain insufficient. Therefore, this study aims to investigate the epidemiological characteristics of emm cluster and emm pattern typing in Chinese Group A Streptococcus (GAS) isolates. Methods: We analyzed 466 GAS isolates from Shenzhen Children's Hospital (2016 - 2020) using emm pattern and emm cluster typing systems. Results: Results showed emm12 was the most prevalent pattern (56.2%), followed by emm1 (29%). Among emm clusters, A - C3 and A - C4 were most prevalent (85.2%). The A - C pattern was most common in emm pattern analysis (91.6%). For invasive diseases, skin and soft tissue infections were most prevalent (35%), and for non - invasive diseases, OSAS and scarlet fever were predominant (72.5%). There were significant correlations between different emm cluster subtypes and GAS - caused non - invasive infections. E6 and A - C5 subtypes correlated with OSAS in non - invasive diseases, and A - C4 branch was associated with skin and soft tissue infections in invasive diseases. Only A - C and E types in emm patterns were significantly associated with OSAS in non - invasive disease. The theoretical coverage rate of the 30 - valent M protein vaccine for Shenzhen - isolated GAS strains reached 98.3% (95% CI, 97 .1–99.3%). Conclusion: This study provides epidemiological information on GAS emm cluster and emm pattern typing in Shenzhen Children's Hospital.