Background: Irrational practicing of antibiotic prescribing adds up to increased morbidity and mortality of pediatric patients, especially with infections such as pneumonia, meningitis, bronchitis, etc. Objective: To determine the prevalence of irrational usage of antibiotics among pediatric patients and its effect on them. Methods: A crosssectional observational study was conducted in a tertiary care hospital for a period of 6-months with 250 pediatric patients from various specializations. The exclusion was based on those with malnutrition, syndromes, congenital heart defects and other concomitant diseases including 80 patients. Medical and laboratory records were made use for the analysis. Results: Common age category of patients were from 0-12 months (57(22.8%)). Mean length of stay was about 6.3 (4; 1-40%). Blood culture reported Staphylococcus aureus (36.6%) to be the prominent organism. Cephalosporin (33.7%) was the commonly prescribed antibiotic class, with tetracycline (11.6%) commonly used as the prophylactic broad-spectrum antibiotic. The mortality rate due to irrational antibiotic prescription was about 37 [PR: 7.21 (1.75 to 22.59, p>0.005)]. Conclusion: Male gender was more liable to infections and mortality due to irrational antibiotic prescribing had been increased significantly in the population requiring monitoring and appropriate screening.