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Current status data on pediatric critical care in Iran are insufficient. This study was performed to identify the characteristics and outcomes of critically ill children admitted to a pediatric intensive care unit (PICU) in Ahvaz, Iran. A retrospective study was carried out among all patients in the PICU at Abuzar Hospital during one year. Medical records of patients who were treated in the PICU were reviewed. A total of 400 patients were identified. Their average age was 29.94±39.55 months and 53.8% of them were males. Nearly half of the patients were under age one. The most common causes of PICU admission were respiratory (36.5%), neurological (18.5%), and infection-related diseases (15%). Besides, 55.7% of patients (n=223) had no history of underlying health problems. Admissions were more frequent in winter (n=125; 31.3%) and spring (n=101; 25.3%). The mean length of hospital stay and mortality rate were 10.79±6.39 days and 15.5%, respectively. In addition, 231 patients had an abnormal respiratory rate and a quarter of them (n=97) required ventilation support. Moreover, 377 and 82 patients were malnourished and severely underweight, respectively. There was a significant association between mortality of patients and having malnutrition, as well as consanguineous parents (p< 0.001). The death rate was significantly higher in patients with infectious disease than non-infectious, as well as long-stay PICU patients than short-stay patients (p<0.05). Further studies are warranted to identify factors contributing to disease burden among PICU patients in Iran to develop appropriate therapeutic strategies and improve the outcomes of pediatric patients.