Abstract: We aimed to describe mode of death and the circumstances surrounding dying a pediatric intensive care unit. A retrospective descriptive study all patients (<15 years) dying in the PICU of tertiary care hospital from April 2004 to Jun 2006 (n = 74). Information regarding sex, age, Length of Stay (LOS), primary and admission diagnosis and the way of death was determined. Deaths were classified in 5 groups: Do not resuscitate (DNR), Withdrawal or Limitation of Therapy (W/LT), failed cardiopulmonary resuscitation (Failed CPR), brain death (BD) and terminal organ failure (TOF). Among 1075 admission, 6.8% patients died. Afton admitted during evening (43%). 40.8% died in the first two days. Failed CPR was the most common mode of death (66.2%), BD was found in 14.9%, TOF in 12.2%, W/LT in 2.7% and DNR in 4.1%. We observed that failed CPR is the most common mod of death and active withdrawal is still not widely practiced in our PICU because pediatricians in developing countries have to consider socio cultural and religious factors when making such decisions.