Background: Acute respiratory infection is a leading cause of morbidity and mortality in infants in developing countries. Hence, the present study was undertaken to study the clinical characteristics, risk factors and prognostic Factors in cases of Acute Respiratory Distress in infants. .Methods: This is a prospective study done in the Department of Pediatrics at a tertiary care hospital in Bihar, India. The study was conducted over a period of two years in which infants presenting with acute respiratory distress as per WHO criteria were evaluated for the clinical profile, risk factors and outcome as per predesigned proforma.  Results: We found a higher incidence of acute respiratory distress among male (55%) infants and infants belonging to lower socioeconomic group (72.5%). Malnutrition (53.3%), lack of exclusive breastfeeding and improper immunization were significantly associated with increased incidence and severity of acute respiratory infections. Conclusions: The Present study has identified various risk factors among acute respiratory distress cases in infants and predictors of severity and outcome. The burden of morbidity and mortality resulting from these can be reduced by promoting exclusive breastfeeding and immunization, effective management of malnutrition, improving the living standards and educating parents about hazards of smoking.