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Introduction: Limited data is available on anemia at discharge from Pediatric Intensive Care Unit (PICU) of Pakistan. To determine the prevalence of anemia among critically ill children discharged from a PICU of public-sector Children hospital. Methods: A retrospective cohort study was conducted on children (1mo-15 years) who had hemoglobin measurement two or more times and last one was done within 24-hour of discharge in the PICU of Children Hospital, Korangi-5 from January to December 2024. Anemia is defined as hemoglobin < 10 g/dL, and severe was Hb < 7g/dl. Data like age, gender, admitting diagnosis and Hb prior to discharge were recorded. Descriptive statistics were applied. Results: A total of 457 patients met the eligibility criteria. The median age at admission was 10 months, and 57.5% were male. The most common admitting diagnoses were respiratory illnesses (52.7%, n = 241), followed by miscellaneous conditions (23.2%, n = 106), of which the majority were infectious diseases. Neurological disorders accounted for 17.3% (n = 79), while cardiovascular conditions made up 6.6% (n = 30). At admission, 259 patients (56.7%) had Hb < 10 g/dL, of whom 35 (13.5%) had severe anemia (Hb < 7 g/dL). The remaining 198 patients (43.3%) had Hb >10 g/dL. At the time of discharge, anemia (Hb < 10 g/dL) was present in 288 patients (63%), including 13 patients (4.5%) with severe anemia (Hb < 7 g/dL). In contrast, 169 patients (37%) had Hb >10 g/dL at discharge. Among those with Hb < 10 g/dL at admission, 76% remained anemic at discharge, while 22.4% showed improvement with Hb >10 g/dL. Conversely, among those with Hb >10 g/dL at admission, 43.9% developed anemia by discharge, whereas 56.1% maintained normal hemoglobin levels. Conclusions: Anemia at discharge is clinically significant as it may contribute to delayed recovery, poor growth, impaired neurodevelopment, and increased risk of hospital readmission. These findings highlight the need to address anemia as part of discharge planning and post-PICU follow-up, and call for further research into modifiable factors and timely interventions.