Children with Chronic Abdominal Pain(CAP) constitute a heterogeneous population comprising of both organic and functional gastrointestinal disorders(FGIDs). The presence of alarm symptoms and signs warrants further investigation. This study was done to understand the clinical spectrum and role of alarm symptoms and signs in managing children with CAP. A prospective observational study was done among children (4–14 years) presenting with CAP to the Paediatric Outpatient department (OPD) of a tertiary rural hospital, Sattur, Dharwad, during the study period November 2015 to October 2016 . Each child was evaluated by a detailed history and clinical examinations as per predesigned proforma. Lab investigations were done if required and in the presence of alarm signs or symptoms. Majority of children with CAP had FGIDs. Mesenteric lymphadenitis was found to be the most common organic cause for children with CAP. Alarming symptoms alone doesn’t help us in classifying CAP into organic or nonorganic