Background: Pediatric intensive care unit (PICU) has improved the outcome of children in developed countries. However, little is known about the PICU outcomes in resource-limited settings. Objective: This study was aimed to investigate outcomes predictors at an Egyptian PICU. Patients and Methods: This prospective study was conducted at PICU of Sohag University Hospital from March 2018 to June 2020. Collected data included patients' demographics, clinical, laboratory parameters, severity of illness scores, management, and length of stay in days. Main outcomes were PICU mortality and functional status deterioration (assessed by functional status scale) on discharge and after 6 months. Outcome predictors were evaluated by multivariable logistic regression analysis. Results: This study included 451 patients. The median (IQR) age was 7 (3 – 24) months. Sepsis was the major diagnosis (60.1%). The PICU mortality rate was 37.9%. Of survivors, 18.9% developed new disability at PICU discharge. At 6 months only 7.5% had a residual new disability. Multivariable analysis showed that presence of multiorgan dysfunction (AOR=44.9, 95%CI (15-134.3), p < /em> <0.001), acute kidney injury (AOR = 11.6, 95%CI (1.82-74.2), p < /em> = 0.009), need for prolonged intravenous fluid administration (AOR = 1.2, 95%CI (1.1-1.3), p < /em> = 0.005), vasoactive inotropic support on first day of admission(AOR = 1, 95%CI (1-1.1), p < /em> = 0.038) and antibiotic escalation (AOR = 4.6, 95%CI (1.5-14.1), p < /em> =0.007) contributed to higher mortality outcome. Conclusion: It could be concluded that the PICU mortality was high while the rate of developing functional deterioration was relatively low. Factors related to sepsis-induced organ dysfunction and its treatment were associated with the poor outcomes.