Background: Diabetic ketoacidosis (DKA) is the most critical medical condition of type 1 diabetes mellitus (TIDM). Hospitalized children with DKA are more likely to develop acute kidney injury (AKI). Objective: This study aimed to evaluate AKI risk factors and incidence in TIDM children hospitalized with DKA. Methods: This one-year prospective observational study that was carried out at El-Mataria Teaching Hospital on 22 children ≤ 18 years old with T1DM hospitalized with DKA. Results: Out of 22 T1DM children with DKA, 17 (77.27%) presented with AKI. 8 (47.06%) had mild, 7 (41.18%) had moderate, and 2 (11.76%) had severe AKI. Serum creatinine on admission was significantly increased in AKI contrasted to non-AKI patients (P value =0.019). Body mass index (BMI) was a significant risk factor for AKI (OR 0.653, 95% CI 0.439–0.971, P value =0.035). Platelets were a significantly greater in AKI cases (P value =0.027). Conclusions: This study found AKI high incidence, with 77.27% of children developing AKI during their hospitalization. Most AKI cases were mild to moderate in severity. The eGFR was significantly less in AKI children, while platelets were a significantly greater in AKI children. The duration of diabetes (newly diagnosed vs. established) was not a significant risk factor for AKI. However, in the univariate regression analysis, BMI emerged as a significant risk factor for AKI, with a higher BMI associated with a lower AKI development risk.