Background: Hospital-acquired infections (HAIs) are a major complication of hospital care in adult and children. Estimating the cost of infection control is important because HAIs cost a lot by extending patient length of stay this is a major risk factor for HAI. Objectives: Estimation of the direct cost of medical infection control measures and the direct cost of hospitalization among patients with and without hospital-acquired infections in the Pediatric Intensive Care Unit at Tanta University Hospital. Subjects and Methods: fifty infants and children (with and without HAI) who were admitted to PICU were subjected to clinical examination and investigation to diagnose infection. The direct cost included feeding requirements, investigations, procedures, medications and infection control measures. Prices used according to the period from October 2016 to September 2017 for calculating patients cost. Results: The average total direct cost of hospitalization, for cases with HAI was 8940.45 EP, which was significantly higher than that for patients without HAI (2935.63 EP). There was a significant difference in the average cost per day between patients with and without HAI. The average total direct cost of management for cases with HAI was 7068.77 E.P, which was significantly higher than that for patients without HAI (2191.66 E.P). The average total infection control cost for cases with HAI was 1871.69 E.P, which was significantly higher than that for cases without HAI (743.96 E.P). The mean length of stay (LOS) in PICU was significantly longer for patients with HAI (19.08 days), while in patients without HAI was 7.44 days (range 4-11). Conclusion: The cost of infection control is much lower than the cost of hospital-acquired infections management that prolongs hospital stay causing financial losses to the health system.