Objective: Our study aims to estimate the incidence of non-convulsive status epilepticus (NCSE) in comatose children and to evaluate response to acute treatment with anticonvulsants. Material and methods: This is a prospective observational cohort study conducted in Pediatric Intensive Care Unit (PICU) of Ain-Shams University. Eighty patients presented with Glasgow coma scale (GCS) <8 and/or the presence of abnormal movements or vital sign fluctuations were enrolled in the study. All were subjected to EEG monitoring for at least 1 hour within 24 hours of presentation. Patients diagnosed as NCSE received anticonvulsant treatment and were reevaluated clinically and by EEG after 1 week. Results: Twenty four patients were diagnosed as NCSE (30%). EEG was normalized in 50% of patients after treatment. Conclusion: NCSE is possible to be under-recognized in the PICU settings because of the pleomorphic clinical features. Clinical suspension of NCSE and EEG monitoring for critically ill comatose children will improve their outcome