Background and objective: The investigation of “why” and “when” deaths are occurring in the PICU will give us insight into the disease types and functioning efficacy of our PICU. Comparison of these deaths with patients who survive and Analysis of the risk factors that may be associated with death can give information that can be utilized to improve clinical practices by anticipating the outcome and provide public health strategies to improve the outcomes of ICU care. Method: This was an analytical observational study, done in PICU, Department of Pediatrics, M.Y and CNBC Hospital, Indore (M.P) over a period of 18 months Included patients admitted to PICU who have stayed for at least 2 hrs. (Case: patients who died, control: patients who survived with no exclusion criteria All appropriate data was collected from admission register of PICU, MY hospital Indore and processed using a SPSS. Result: hundred cases and hundred controls were included in study, maximum deaths were seen in 3months to 3 year of age group, other causes were low socioeconomic status, farther distance, had delayed development or malnourished, with maximum mortality due to respiratory causes followed by CNS followed by CVS than GIT and other system involvement. Conclusion: Lower socioeconomic status, underlying chronic illness, developmental and nutritional status, farther distance from hospital, specific parameters (respiratory, circulatory, central nervous system, haematology) are significant factors influencing probability of death among critically ill children. Whereas age, gender, time to reach PICU, gastroenterology parameters show no significant differences.