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Background and objectives Urinary tract infections (UTIs) are the most common serious bacterial infections during the first year of life. Symptoms of UTI in young children are non-specific, making diagnosis challenging. Method We conducted a retrospective single-center study over a period of 5 years. Urine samples collected by suprapubic aspiration, clean catch, or bladder catheterization in children aged 0–12 months presenting to the emergency department with fever without focus and suspected UTI during this period were reviewed from the laboratory archives. We divided our population into two groups of 0–3 and 4–12 months. Data on dipstick urinalysis were collected, with urine culture as the reference standard. Statistical analysis—including sensitivity, specificity, diagnostic odds ratio, likelihood ratio, positive predictive value (PPV), and negative predictive value—was performed for the following dipstick urinalysis parameters: leucocyte esterase alone, nitrites alone, leucocyte esterase and nitrites, leucocyte esterase and/or nitrites. Results Statistical analysis showed that in the 0–3-month group, specificity was 94% for leucocyte esterase (LE) and 99% for nitrites (Nit). Sensitivity was 60% for LE and 25% for nitrites. PPV was 87% for LE and 96% for nitrites. In the 4–12-month group, specificity was 91% for LE and 98% for nitrites. Sensitivity was 71% for LE and 25% for nitrites. PPV was 82% for LE and 87% for nitrites. Combined analysis of leucocyte esterase and/or nitrites and leucocyte esterase and nitrites showed no improvement in performance. Conclusion Dipstick analysis is a reliable bedside test for ruling in UTI in children under 12 months, particularly in the presence of positive nitrites for children less than 3 months of age. Urine culture remains necessary for diagnostic confirmation. Article summary This study adds to the diagnostic performance of dipstick urinalysis in infants and neonates, with a specificity of 92%–99% and positive predictive value of 82%–96%.