Background: One of the biggest problems with healthcare-associated infections is multidrug-resistant organisms (MDROs). Objective: To determine the frequency and the outcome of MDRO infections among pediatric intensive care unit (PICU) patients at Minia University Hospital, Egypt. Patients and Methods: This retrospective cross-sectional study was conducted on 202 pediatric patients who were admitted during the period from December 2021 to July 2022 in the pediatric intensive care unit in Minia University Children's Hospital. Results: The culture results revealed that out of the 202 evaluated patients, 70 (34.7%) were MDROscarriers, and 30.0% of these MDROs were Klebsiella species. The majority of MDROs were isolated from endotracheal tubes in 32 (45.7%) followed by blood culture in 27 (38.6%). Extended-spectrum beta-lactamase (ESBL) among MDROs was 25 (35.7%). A statistically significantly higher mortality was detected in patients with MDROs 44/70 (62.9%) versus non-MDRO patients 20/132 (15.1%) (p=0.005). Moreover, MDROs infection has increased in frequency among patients with chest infections 27 (38.6%). Additionally, patients infected with MDROs had significantly greater PICU stay compared to the non MDROs patients (Mean ± SD of 11.59±4.80, p=0.006). Conclusion: The frequency of MDROs (34.7%) was high among PICU cases in Minia University Hospital. Klebsiella species were the most prevalent MDROs, followed by Staph aureus species. Infection brought on by Gram-negative organisms occurs significantly more frequently than infection brought on by Gram-positive species. Programmes for strict infection control should be adopted.