This study planned to determine the prevalence, etiology and factors predictive ofoutcome of infants and children admitted to emergency department due to acute nontraumaticcoma. So all patients of non- traumatic coma between 1 month to 12 yearsadmitted to emergency department in the pediatric specialized hospital- Cairo Universitywere studied. The Incidence is 11.8%. By logistic regression, low Glasgow coma score,positive past history of underling disease at admission and abnormal respiratory pattern,presence of seizures at 48 hours after admission were independent significant predictorsof death and Abnormal motor pattern significant predictors of disability. Concluding that;CNS infections and metabolic condition were the most common causes of non-traumaticcoma in childhood. Simple clinical signs were good predictors of outcome.