Background: Dengue fever is a significant public health concern in tropical countries, with children often presenting with atypical features and rapid clinical deterioration. Coagulation abnormalities are common in dengue and may lead to life-threatening complications such as bleeding, shock, and multiorgan dysfunction. Early recognition of laboratory derangements and their clinical relevance is vital for timely intervention and improved outcomes. Objective: To evaluate the prevalence and spectrum of coagulation abnormalities in pediatric patients diagnosed with dengue fever and to correlate laboratory findings with clinical severity and bleeding manifestations. Methods: This hospital-based observational study was conducted over six months from June 2024 to November 2024. A total of 200 children aged 1 to 18 years with laboratory-confirmed dengue infection were included. Coagulation parameters such as platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT) and international normalized ratio (INR) were assessed. Clinical data including bleeding symptoms, dengue classification and outcomes were recorded. Statistical analysis was performed to identify correlations between laboratory values and clinical severity. Result: Of the 200 children studied, thrombocytopenia was observed in 82.5% and prolonged PT or aPTT in 38%. Clinical bleeding manifestations were present in 29.5% of cases, most commonly epistaxis, petechiae, and gum bleeding. Children with severe dengue exhibited significantly lower platelet counts and more frequent coagulation abnormalities compared to those with non-severe disease (p < 0.05). APTT prolongation was notably associated with mucosal bleeding. INR >1.5 was observed in 12% of cases and strongly correlated with clinical severity and prolonged hospitalization. Conclusion: Coagulation abnormalities are prevalent in pediatric dengue fever and show significant correlation with disease severity and bleeding manifestations. Monitoring coagulation profiles alongside platelet count provides valuable prognostic information and should be integrated into routine evaluation to guide supportive care and prevent complications.