Background: Respiratory tract infections (RTIs) are among the leading causes of childhood morbidity and mortality worldwide, particularly in developing countries. They account for a substantial proportion of outpatient visits, hospital admissions, and antibiotic prescriptions. Understanding the clinical spectrum of RTIs is essential for timely diagnosis and appropriate management.Objective: To evaluate the clinical spectrum, demographic characteristics, etiological distribution, and outcomes of respiratory tract infections among hospitalized children.Methods: A hospital-based prospective observational study was conducted among 250 children aged 1 month to 12 years admitted with respiratory tract infections between January 2024 and December 2024. Clinical presentation, laboratory findings, radiological investigations, treatment, and outcomes were recorded and analyzed.Results: The mean age of the study population was 3.9 ± 2.8 years, with males accounting for 58.4% of participants. Upper respiratory tract infections (URTIs) constituted 44.0% of cases, while lower respiratory tract infections (LRTIs) accounted for 56.0%. Pneumonia (32.0%) was the most common diagnosis, followed by bronchiolitis (18.0%), viral upper respiratory tract infection (16.8%), acute pharyngotonsillitis (14.4%), acute otitis media (8.8%), croup (5.2%), and sinusitis (4.8%). Fever (88.0%), cough (86.0%), rhinorrhea (60.0%), tachypnea (46.4%), and wheezing (34.8%) were the predominant symptoms. Most children recovered completely, while 12.8% required pediatric intensive care unit (PICU) admission.Conclusion: Childhood respiratory tract infections remain a major cause of pediatric hospitalization, with pneumonia and bronchiolitis representing the most frequent lower respiratory tract infections. Early diagnosis, vaccination, adequate nutrition, and prompt treatment contribute significantly to improved outcomes.