Methods: A retrospective study was performed in the pediatric department of the Hospital for Infectious Disease in the city of Lviv, Ukraine, from January 2004 through December 2007. The CDC criteria were used as the standard definition for NI. NI rates were calculated as a density incidence rate (per 100 patient-days). Results: Overall, 195 children with salmonellosis were admitted to the hospital during the study period. Of these, 14 infants died. Salmonellosis was confirmed in all of these patients by isolation of salmonella from feces and urine. There were 3 serotypes: S. typhimurium (65.5%), S. enteritidis (32.7%), and S. tennesse (1.8%). Hospital-acquired salmonellosis occurred in 55 patients, with an incidence of 2.8 per 100 patient-days. The diagnosis was based on recurrent episodes of fever and diarrhea (33.3%) while in the hospital setting and a history of prior hospitalization in other hospitals for pneumonia, sepsis, otitis media, bronchitis, or diarrhea within 3 to 10 days before admission (66.7%, mostly infants). Most cases (66.5%) were admitted during the winter-spring season, which is classic for nosocomial infection. Multi-drug resistant S. typhimurium, type “a”, was the most common (61.5%) isolate. The most frequent manifestations of NS included severe infection with multiple system failure, presenting with toxic shock followed by bacterial metastasis (meningitis, muscles abscess, lymphadenitis, otitis, osteomyelitis, endocarditis) and complications, such as anemia, hypotrophy, and extraintestinal foci of inflammation. Conclusion: NS is a life-threatening disease, especially in young patients. S. typhimurium, type “a” was the main causative agent of NS in the Lviv district. Given increasing antibiotic resistance and the lack of an effective nosocomial surveillance program in Ukraine, preventive strategies are critical to reduce disease incidence.