Background: Pediatric cancer patients are at greater risk of infection due to their impaired immunity and intense anticancer therapy. So, the use of antibiotics in these patients is common to reduce the incidence of infection. Aim: Evaluation of infection risk and antibiotic exposure for patients admitted to the pediatric oncology unit. Methods: The study was carried out in the Pediatric Hematology and Oncology unit, Zagazig University Hospitals over a year from September 2018 to September 2019. The study included 80 patients attending to the unit. All patients were subjected to full history taking, clinical examination, routine laboratory investigations and assessment of risk factors of infection. Culture and sensitivity tests were done to evaluate the antibiotic exposure, guide the antibiotic choice and revise prescription orders. Results: According to distribution of risk factors of infection among the studied group, we found that all group were immuno-compromised with peripheral intravenous catheters and took immunosuppressive drugs, 53.8% had increased length of stay and 50% did personal hygiene, no one had surgery or urinary devices. The blood culture results distribution revealed that (81.25%) had no Growth and (18.75%) were infected, the majority were Staphylococcus aureus and E coli (5%) and (3.75%) respectively. Regarding the results of the cultures, the most antibiotic that had the highest percentage of sensitivity among the bacterial organisms discovered was Tigecycline (71.4%). Conclusion: Avoiding the risk factors of infection helps in decreasing the incidence of infection among cancer patients. Prescription of antibiotics must be according to the culture results.