Epistaxis is a common childhood symptom that may prompt a referral to a pediatric hematologist or otolaryngologist . Epistaxis also is the most common bleeding symptom and may herald the presence of bleeding disorders.Objectives: to evaluate children and adolescents presenting with epistaxis and determine variables that can predict an underlying bleeding disorder and if they varied among both age groups. Methods:Sixty three cases of pediatric patients with recurrent epistaxis who presented to the ENT Pediatric outpatient clinic as well as Hematology outpatient clinic, Cairo University Pediatric Hospital.The study also included those presenting with acute severe epistaxis to the emergency department(ED) whether ENT or Pediatric as well as those required admission to inpatient wards.Patients included in the study from June 2010 to December 2010 were subjected to detailed history taking with emphasis on :history of bruising and/or other bleeding symptoms, family history of a bleeding disorder( epistaxis,menorrhagia or bleeding on hemostatic challenge as surgery or dental extraction )and treatment received. Results:There were 33boys and 30 girls with a mean age of 6.08 years ( range 2-18 years).Fourty -eight percent (n=30) had bleeding disorder and 52%(n=33) did not. The most common bleeding disorder was platelet abnormalities; idiopathic thrombocytopenic purpura (ITP) in 8 patients and 7 had platelet dysfunction, 4Glanzmann's thrombasthenia and 3Bernard Soulier syndrome. One patient had aplastic anemia ,one hemophilia A and one vWD type 1. However, 12 cases were considered as unclassified bleeding disorder.Positive consanguinity, duration of epistaxis,epistaxis score and other bleeding symptoms were predictive in those with bleeding disorder(p< 0.001) .The age ,sex ,family history and recurrence had no predictive value. Patients with bleeding disorder had lower median hemoglobin level(Hb)( 10.10 vs. 12.00 gm/dl; p< 0.001), lower median platelets count (plt)( 199.50 vs. 364.00×109/L; p< 0.001) and longer median activated partial thromboplastin time (aPTT)( 30.50 vs. 27.00; p< 0.001). In children with age of onset≤ 10 years only duration of epistaxis and aPTT found to be statistically significant (p <0.05) Conclusion: Fourty -eight percent had bleeding disorder.A positive consanguinity , duration of epistaxis,epistaxis score , other bleeding symptoms, low hemoglobin level, low platelets count and prolonged activated partial thromboplastin time are useful predictive data. In children with age of onset ≤ 10 years the duration of epistaxis, in association with APTT were statistically significant(p < 0.005)and so indicating that these variables can be predictors of an underlying diagnosis.