Background: Pain is an unpleasant sensory and emotional experience related to actual or potential tissue damage. Pain is the most misunderstood, under diagnosed, and under treated/untreated medical problems, particularly in children. There is limited evidence regarding pediatric pain management practice among nurses in hospitalized children in Ethiopia. Objective: To assess practice and factors associated with pediatrics pain management among nurses working in Bahir Dar city public hospitals, Amhara region, Ethiopia, 2022. Methods: Institutional based cross sectional study design with concurrent mixed research method was conducted from November 1 to 30-2022. 403 nurses were selected by Simple random sampling technique for quantitative study and purposively selected eight nurses were included for qualitative study. A structured self-administered questionnaire and semi structured in-depth interview was employed for data collection. Epi info version 7.1 and SPSS version 25 was used for data entry and analysis. ATLAS ti version 7.0 and thematic analysis was used for qualitative study. Binary logistic regressions were done to identify independent variables associated with outcome variable at p <0.05 with 95% confidence interval. For quantitative, Hosmer and Lemeshow test was checked for model goodness of fit, which was 0.71. For qualitative, trustworthiness of the data was checked. Result: Nurses who had good practice of pediatrics pain management among hospitalized children was 216 (53.6%) (95% CI- 48.4% to 58.3%). Knowledge [AOR= 3.95; 95%CI: ( 2.30, 6.79)], Attitude [AOR=2.57; 95% CI: ( 1.53- 4.30)], qualified in BSC pediatrics and child health nurses [AOR=6.53; 95%CI: (1.56-27.25)], year of experience in pediatrics unit [(AOR=1.92; 95% CI: (1.03-3.56)] and gating pain management training [AOR=3.31; 95% CI: (1.73-6.33)] were significantly associated with the pain management practice of nurses. Four themes, those are inadequate knowledge of pain assessment and pain management practice, inadequate professional commitment and satisfaction, weakness of hospital administrators and knowledge, culture and economic status of the family were main themes. Conclusion: The practice level of nurses in pediatrics pain management was not satisfactory according to the standard of pain free hospital initiative implementation guidelines. Therefore, the hospital‟s administrative bodies would better to provide appropriate professional education, training program regarding to pain management for nurses, fulfill all analgesics used to treat pain and for hospitals better to build children playing room. Key Words: pediatrics Pain management, Hospitalized Children, Nurses, Bahir Dar