Objective: Mechanical ventilation (MV) is a life saving invasive procedure that is used in critical pediatric patients to maintain gaseous exchange. In this study, our aim is to explore the various causes and outcome of MV in our PICU patients with special reference to prolonged ventilation and hospital stay, mean duration of stay and immediate outcome of such patients. Materials and methods: In this study, we present the data of 72 mechanically ventilated patients out of a total of 907 admissions to our PICU during a period of 15 months. The data has been retrieved from medical records of the hospital. Results: MV rate was 7.93% with a male to female ratio of 2.4. MV due to respiratory causes was the most common (40.28%) followed by neurological causes (27.78%). Pressure SIMV mode was the most preferred mode of MV (84.72%) and T-piece was the most preferred weaning mode (36.11%) with a mean duration of weaning of 20.14 hours. Prolonged MV (>72 hours) was required in 44.45% and prolonged hospital stay (>10 days) in 59.72%%. MV related complications were seen in 26.39%, VAP (6.94%) being the most common. Study subjects with elective intubation and neurological disorders has better outcome. Mean ventilator days were 2.63 (3.6 days in discharged patients). Successful extubation was achieved in 61.11%. Death rate was 26.39%. Conclusion: Timely availability of adequate services including transport and referral play an important role in reducing the mortality and improving the outcome in terms of morbidity and mortality.