Background: Diabetic ketoacidosis (DKA) is an acute and life-threatening situation that accounts for themajority of diabetes-related morbidity and mortality in children and adolescents who suffer from type 1 diabetes mellitus (T1DM). Objective: To assess pediatric patients presented with DKA regarding aspects of presentation, findings, and management and probable risk factors associated with DKA. Methods: a retrospective descriptive hospital-based study of 43 pediatric patients. Categorized into two groups, Group A: n=18, previously diagnosed T1DM children and Group B: n=25, newly diagnosed cases of T1DM admitted into Pediatric ICU at Alzahraa Hospital,during the period 2013 to 2017.The following data were analyzed: age, sex, weight loss, basic signs & symptoms, severity on admission, blood gas, blood glucose, glycated hemoglobin,risk factors, length of stay, and complications such as electrolyte disturbances were compared between the two groups. Results: Newly diagnosed diabetics accounted for 25 (58.1%) of the patients. Patients in group B had longer hospital stay of 5.88±2.55 days.This study reported more nausea, vomiting, polydipsia, and polyuria, and showed more weight loss (p =.017)in group B. There was a significant relationship between hypokalemia and clinical severity (P = 0.012), and between lower bicarbonate,acidosis and severity of DKA (P <.001). No deaths occurred. Conclusion: DKA was most prevalent in newly diagnosed T1DM cases. Significant differences in severity between groups were observed.Infections was the most common precipitating factors. No lethal complications were reported.