Purpose/Significance To evaluate an artificial intelligence (AI) assisted assessment system for bone age in children’s hand X-ray images based on real-world data from the hospital. Method/Process Data are collected from 1 101 patients who came to the hospital from January to July 2023 for bone age assessment by hand X-ray images. Statistical methods such as mean absolute error, root mean square error, and intraclass correlation analysis are used to evaluate the clinical application value of the AI system from the aspects of effectiveness and appropriateness. Result/Conclusion The AI system has high validity and appropriateness, which is helpful for daily clinical bone age assessment by radiologists.