BACKGROUND፡ A few studies are available from Africa on the use of mechanical ventilation (MV) in the pediatric intensive care unit (PICU). Knowledge of the outcome of patients on MV is critical for better use of resources. We aimed to assess the characteristics and outcomes of mechanically ventilated pediatric patients in Tikur Anbessa Specialized Referral Hospital, Addis Ababa, Ethiopia.METHODS: A cross-sectional study was done from September 2016 to February 2018. Data were reviewed from the patients’ medical records. SPSS version 21 software was used for data entry and analysis.RESULTS: There were 536 patients admitted to PICU; out of these, 202 (41.2%) were on MV. Sixty-three-point six percent of the participants were males and 130 (59.1%) died. The most common indications for the initiation of MV were respiratory problems 46 (20.9%) and 30.59/1000 ventilator days developed complications. Ventilator-associated pneumonia accounted for 18.6% of the complications with 20.9/1000 ventilator days. Survival of medical cases was better than the surgical cases (including trauma); [AOR= 0.13, 95% CI (0.04-0.41)] and those who have MV for more than 3 days are 79% more likely to die (p=0.003). Those who have multi-organ dysfunction syndrome (MODS) [AOR= 0.181, 95% CI (0.08, 0.412)] and high PIM II severity score [AOR= 35, 95% CI (1.7,11)] had higher mortality rate.CONCLUSIONS: higher PIM II score, MODS, length of stay, and being a surgical patient increased the risk of mortality. Early resuscitation and thorough follow up of these ventilated patients are necessary.KEYWORDS: Mechanical ventilation, Mortality, Pediatric, intensive care, PIM II, Ethiopia