Background: Pediatric intensive care unit, usually abbreviated to PICU, is an area within a hospital which is specialized in the care of critically ill infants and children. It is typically directed by one or more pediatric intensivists or PICU consultants and staffed by doctors, nurses, and respiratory therapists who are specially trained and experienced in pediatric intensive care. There are limited data on pediatric Intensive Care in resource limited countries. Most studies done on patient characteristics and treatment outcome are obtained from developed countries that provide treatment with high level health care professionals and advanced equipment. Objective: To assess Admission pattern, Treatment outcome and associated factors of patients admitted to pediatric Intensive Care unit, Tibebe Gion Specialized Hospital, Bahir Dar, Ethiopia, 2022 Methods; A retrospective cross sectional chart review of all patients from January 2020 to August /2022 who were admitted to Pediatric Intensive Care Unit and those who meet the inclusion criteria were used . All the necessary Data were collected from the patients’ charts by using the pre-developed data collection format. The data were entered to epidata version 4.6 and then exported to SPSS 25 version software for analysis. Logistic regression analysis was used and those variables with p-value <0.05 at 95% CI were declared as statistically significant. Results: In this study, the proportion of death among patients admitted to PICU was 17.8%. The odds of patients with length of stay less than or equal to one day admission at pediatric intensive care unit (AOR = 6.1; 95% CI (4.9-18), the odds of patients who were on mechanical ventilation (AOR=4.3; 95%CI (1.7-10)) and patients who had use vasopressor (AOR=6; 95%CI (2.9-18) were the factors significantly associated with the outcome of patients at PICU. Conclusion and Recommendation: In this study the proportion of death among patients admitted to PICU was found to be high. The most common causes of admission were complicated meningitis with ICP, and respiratory problem (complicated pneumonia, TB, status asthmatics). The most common cause of death was multi organ failure Length of stay less than one days of admission, use of vasopressor and use of a mechanical ventilator were statistically significant predictors of mortality. It is recommended that The Ethiopian Federal Ministry of Health and the Regional Health Bureau should better to focus on infectious disease prevention and treatment. We also recommend TGSH to organize PICU with Pediatric Intensivists and respiratory therapists. Key words: proportion of death, PICU, Tibebe Ghion, Ethiopia Abbreviations