Background: – Mortality is the most frequently assessed outcome. So, it is very important to look for the predicting factors of PICU mortality including PRISM III score. Aim: – To assess the risk factors contributing to the increased mortality in our PICU. Material and methods:– This is a prospective observational study done at NSCB Medical college Jabalpur, India .Standard demographic, clinical and laboratory data was obtained prospectively from all the patients stayed in PICU for >6 hours. Patients who had history of chronic disease were excluded. Patient’s hospital course followed to determine the early outcome of their acute sickness (as dead or survived). Results: – Out of 138 patients admitted to the PICU, 22 (15.9%) patients died. Children with acute respiratory distress syndrome at admission were at 5.4 times higher risk of death (95% CI: 2.33–8.59). Children with PRISM III scores of >10 were at 3.4 folded higher risk of death in the PICU (95% CI: 1.4–5.4). Children with PICU stay >4days,Sepsis and Congestive cardiac failure at presentation were having 1.31,1.79 and 1.82 folds higher risk of death with the values of 95% CI of 0.93–1.73, 0.29–3.29 and 0.82–2.82 respectively. Conclusion:–we conclude that In addition to PRISM III score ARDS at admission and , Congestive cardiac failure were independent predictors of mortality in PICU.