A gatekeeper at a Beijing kindergarten went on a rampage, stabbing 15 children and three teachers with a kitchen knife on Wednesday, according to Chinese state media.
A four-year-old boy died later from injuries inflicted in the attack.
Another child and one teacher were detained in hospital with serious neck wounds and were in a critical condition.
The incident at the school, run by the Number One hospital of Beijing university, left children terrified and "covered in blood", according to the country's official Xinhua news agency.
The report added: "Thirteen of the children had light injuries but their heads were bound with bloody bandages."
A suspect was detained and identified as Xu Heping, a 51-year-old man who is believed to have a history of schizophrenia.
He had worked at the kindergarten for two years, according to a police spokesman.
It is believed that the alleged attacker was a psychiatric patient at a Beijing hospital for five months in 1999.
The website sina.com said Chinese authorities received reports soon after 9:30am that a man had been "hacking people up at the kindergarten".
Eight police officers rushed to the scene. The police, teachers and the headteacher of the kindergarten fought with the alleged attacker, who was wielding a kitchen knife, and managed to overpower him.
One eyewitness reported that he had helped police to escort several injured people to the hospital after hearing the commotion.
"I saw the children lying on the ground - there was blood on the floor," said the man, who identified himself only as Mr Xu.
Most Chinese students are on summer vacation, but it is believed that 23 children were in the kindergarten at the time of the incident.
According to the China Daily website, Xu Heping had worked at the kindergarten for two years as a doorman.
It also reported that the alleged attacker had shown no signs of abnormal behaviour prior to the incident.
The man is now being questioned by police. The motive for the attack remains unknown. (AP)