Introduction: Globally, Most pediatric critical illness is managed outside of formal intensive care units, as such we lack an understanding of the true prevalence of pediatric critical illness. Global PARITY (Pediatric Acute cRitical Illness point prevalence sTudY) is a prospective, observational, international study designed to measure prevalence of and outcomes associated with pediatric acute critical illness in resource-limited settings. We hypothesized that availability of pediatric critical care resources (formal and informal) impacts clinical outcomes. Data collection completes in Sep 2022; here we describe preliminary findings. Methods: Children 29 days-14 years with acute illness or injury presenting to a hospital in RLS settings were enrolled during 4 sampling periods over 12 months. Participating centers were not required to have a dedicated pediatric ICU. Admitted children were followed for clinical outcomes and critical care resource utilization. The primary outcome was prevalence of acute critical illness, defined as death within 48 hrs of presentation, need for a higher level of care, or requiring intensive care resources (e.g., Vasoactive). Results: study launched in July 2021 with 63 centers; 47 centers completed >3 data collection periods and over 7000 subjects were enrolled. Data completion and quality review for the 4 sampling periods are underway. A subset of data showed the availability of intensive care units: Pediatric high dependency/intermediate care unit (33, 52.4%), PICU (45, 71.4%), Pediatric beds in adult ICU (8, 12.7%), another subset of data showed patient utilization; Invasive Mechanical Ventilation requirement (N=8055): Yes (48, 0.6%), Vasoactives use: Yes (83, 1.0%). admission location (N=885): Inpatient Ward (600, 67.8%), High-Dependency Unit (266, 30.1%), Intermediate Care Unit (6, 0.7%), Intensive Care Unit (6, 0.7%). Conclusions: The majority of sites reported having a formal PICU. However, resource availability varies significantly between PICUs and this analysis, as well as the association between resources and outcomes, is in process. Global PARITY is a necessary step in determining the global burden of pediatric critical illness and availability of critical care resources; it will provide important insights regarding future resource investment and allocation.