The objective was this study to investigate the effect of spleen aminopeptide combined with xinxibao on erythrocyte immunity and Toll-like receptors (TLRs) signaling pathways in adjuvant treatment of children with recurrent respiratory tract infections (RRTI). A total of 138 children with RRTI admitted to our hospital from May 2017 to May 2019 were selected as the study subjects and randomly divided into 3 groups with 46 cases in each group. The 3 groups were given conventional treatment. On this basis, control group A was given spleen aminopeptide adjuvant treatment, the control group B was given xinxibao adjuvant treatment, while the observation group was given xinxibao combined with spleen aminopeptide adjuvant treatment. Statistical comparison was made on the clinical efficacy, clinical symptom improvement time and trace element calcium (Ca), zinc (Zn) content, peripheral blood T lymphocyte subsets (CD4+, CD8+), erythrocyte immunity indicators [Cooperative Tumor Erythrocyte Rosette (ATER), Erythrocyte Immune Adherence Enhancing Factor (FEER), Erythrocyte Immune Adherence Inhibiting Factor (FEIR)], Toll-like Receptor 2 (TLR2), Toll-like Receptor 4 (TLR4) level related to the TLRs signaling pathway before treatment, 2 weeks and 4 weeks after treatment. The observation group had higher total effective rate of clinical treatment than the control groups A and B, faster disappearance of high fever, cough, and pulmonary rales than the control groups A and B, showing statistically significant difference (P<0.05); after 2, 4 weeks of treatment, the observation group had higher contents of trace elements Ca and Zn than the control groups A and B, lower TLR2 and TLR4 levels than the control groups A and B, showing statistically significant difference (P<0.05); after 2, 4 weeks of treatment, the observation group had higher ATER, FEER, CD4+, CD4+/CD8+ levels, lower FEIR and CD8+ than the control groups A and B, showing statistically significant difference (P<0.05). It is concluded that the combination of spleen aminopeptide and xinxibao in adjuvant treatment of RRTI can alleviate children’s symptoms, enhance peripheral T lymphocyte subsets, erythrocyte immunity, supplement trace element content, regulate TLRs signaling pathway, and further improve the therapeutic effect.