Background: Mechanical Ventilation (MV) has become frequently used life-supportive management in Pediatric Intensive Care Units (PICU). But very little data is available from developing countries regarding the outcome analysis coupled with clinical profile of children ventilated in PICU. Hence the present study was undertaken to assess the etiological and clinical profile of ventilated children in PICU of tertiary care centre. Method: Total number of PICU admissions during the study period from Feb 2021 to Dec 2022 was 678. Out of them a total of 272 (40.11%) PICU admissions satisfied the inclusion and exclusion criteria were studied. Results: The average age of infant was 30.42±46.14 months with male preponderance (57.72%). The most common etiology/indication was respiratory diseases (29.77%). Invasive ventilation (98.89%) far exceeded the use than non–invasive ventilation (1.10%) in our PICU. Of the children who were ventilated in the PICU, 76.6% were intubated at the Emergency Department. The commonest cause for intubation was circulatory failure and the most common clinical diagnosis was septic shock. Rapid Sequence Intubation (RSI) was done by the majority of children (53.90%). Maximum cases250(92.93%) were exclusively mechanically ventilated. Nosocomial pneumonia was the most common complication encountered in ventilated children(16.35%). The mortality in the ventilated children was 54.77%. Conclusion: Mortality and complications in ventilated children in the PICU can be reduced with increased availability of mechanical ventilators and timely referrals to tertiary care centre. However, to improve the outcome of mechanically ventilated children in PICUs, the early and effectively identification of clinical profile and etiological factors associated with ICU admission.