Acute respiratory distress syndrome (ARDS) is a severe clinicalsyndrome of acute lung injury, noncardiogenic pulmonary edema andsevere hyopxia. There are no reports on the magnitude of problem of thisentity and its predisposing causes in the pediatric age group in Egypt. Thepresent study was undertaken to examine the pattern of ARDS in apediatric intensive care unit (PICU). This research follows cohort analytical study design, 20 pediatricshypoxic patients needing mechanical ventilation constituted the studygroup. The records of the children admitted to PICU from January 2004 to January 2007 were reviewed. Based on the results of the present study, the following can beconcluded: 1)The incidence rate of ARDS in the PICU is 13.9 /1000admissions. 2)The most common cause of ARDS was due to direct lunginjury due to pneumonia. 3) Morality rate was 85%, mostly due torespiratory failure. Based on the results of the present study further studies arerecommended to study the incidence pattern of ARDS in other PICUS inEgypt