Background : Dysnatremia and dyskalemia are common causes of clinical concern while managing critically ill children in Pediatric Intensive Care Unit (PICU). Methods : A retrospective audit of PICU admissions (January 2016 to December 2016) at Kalawati Saran Children’s hospital, New Delhi, was conducted. Children aged 1 month to 18 years were included and data related to age, sex, duration of hospital stay, diagnosis, and mortality was collected. Values of serum sodium and potassium at admission were recorded. Serum sodium level between 135-145 mEq/l was considered as normal. Hypernatremia was defined as serum sodium >145 mEq/l (mild: 146-149, moderate: 150-169, and severe: = 170) and hyponatremia as serum sodium concentration of < 125). Serum potassium level between 3.5-5.4 mEq/l was considered as normal. Hypokalemia was defined as a serum potassium level < 2.5) and hyperkalemia as serum potassium level =5.5 mEq/l (Mild: 5.5-6.0, Moderate: 6.1-7.0, and Severe: > 7.0). Children with dysnatremia and dyskalemia were managed as per standard treatment protocols. Univariate logistic regression analysis was performed to evaluate the relation between admission dyselectrolytemia and mortality. Results : A total 745 children (mean age 67.2±57.7 months, M:F ratio 429:316, mean duration of stay 8.6±11.4 days) were admitted in PICU during study period. Mortality was reported in 96(12.8%) children. The data for sodium values was available in 638 children. Hyponatremia was observed in 125 (19.6%) children (mild-69.6%, moderate-22.4%, and profound-8%) and hypernatremia in 124 (19.4%) children (mild-45.2%, moderate-50%, and severe-4.8%) during study period. In hyponatremic patients, the most common diagnosis were infections (42.4%) followed by renal (17.6%) and respiratory (12.8%) disorders. The most frequent diagnosis in children with hypernatremia was infections (41.9%), followed by respiratory (13.7%), and renal disorders (12.9%) respectively. Hyponatremia (OR: 1.51±0.42, p=0.137) and hypernatremia (OR: 1.04±0.322, p=0.89) were not significantly associated with mortality. Data for potassium values was available in 662 children. Hypokalemia was observed in 117 (17.7%) children (mild-50.4%, moderate-31.6%, and severe-18%) and 116 (17.5%) with hyperkalemia (mild-50%, moderate-36.2%, and severe-13.8%). The causes of hypokalemia were infections (46.1%) followed by renal (14.5%), and respiratory disorders (8.5%) and the causes of hyperkalemia were infections (38.7%), respiratory (23.2%), and renal (20.7%) disorders. Both hypokalemia (OR: 1.30±0.38, p=0.361), and hyperkalemia (OR: 0.92±0.296, p=0.8) were not significantly associated with mortality. Conclusion : Electrolyte abnormalities are common in critical children admitted to PICU. These are mostly seen in infections, followed by renal and respiratory disorders. Burden of dyselectrolytemia in PICU is significant with 39% and 35% of children having dysnatremia and dyskalemia respectively. Electrolyte derangements require definitive corrective measures and contribute to morbidity; however, we did not observe an association with increased mortality. Strengths of study include a large sample size however, our study is limited by its retrospective design and missing data in a number of included children.