Ketotic hypoglycemia is the most common form of childhood hypoglycemia. Periods of Hypoglycemic episodes typically occur during early morning, especially during intercurrent illness when food intake is limited. The symptoms and signs of hypoglycemia are often overlooked .Because hypoglycemia is a life threatening event can lead to severe neurological sequel, intravenous administration of glucose is necessary. These children respond promptly to glucose. We share our experience of four cases of Ketotic hypoglycemia admitted during last 2 years.