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Objective: The World Health Organization (WHO) updates SAM management protocol regularly but still it is not clear whether Vitamin K should be given to SAM children or not. But in our institute we observed that many children of complicated SAM had various bleeding manifestations on admission that's why we planned to study the evaluation of vitamin K deciency and effect of vitamin K in complicated SAM. Methods: It was a hospital based prospective interventional study conducted in 150 complicated SAM children, 100 in group A and 50 in group B. Group A children received Vitamin K 5 mg via intravenous route on admission while group B did not received Vitamin K. The PT-INR, aPTT along with routine investigations were done on admission in both the groups. Repeat PT-INR and aPTT were done after 24 hours of Vitamin K administration in group A and before discharge (on day 10 of admission) in group B children who had abnormal INR on admission. All the collected data were managed and analyzed with standard software Biostatics (SPSS Version 20) Results: Forty two (28%) out of 150 children, 27 in group A and 15 in group B had abnormal INR on admission. In group A, 12 (44.4%) children had bleeding manifestations and most of children (66.6%) had GI bleeding and Malena. In group A, After 24 hour of vitamin K administration all 27 children had signicant improvement in INR and 20 out of 27 with abnormal aPTT had signicant improvement in aPTT. But in the group B where no vitamin K was administered more than 50% had persistence of abnormal PT, INR and aPTT on day 10 of admission. Conclusion: More than one fourth complicated SAM children had vitamin K deciency and signicant improvement was seen in children who received vitamin K on admission compared to children who did not receive vitamin K and kept on diet alone.