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BACKGROUND: Tetanus is an acute vaccine preventable illnessmanifested by neuromuscular dysfunction due to a potent exotoxin,tetanospasmin produced by Clostridium tetani. It is a commonhealth problem in developing countries like Ethiopia. The aim ofthis study was to assess clinical profile and outcome of Pediatricstetanus in a referral hospital, South Ethiopia.METHODS: This is a retrospective cross-sectional study of medicalrecords of 24 Pediatric tetanus patients who were admitted fromJuly 2014 to June 2016 to the Pediatrics Department of HawassaUniversity Comprehensive Specialized Hospital, Hawassa-Ethiopia.Tetanus was diagnosed clinically. Data were entered and analyzedusing SPSS statistical software.RESULTS: The median age at diagnosis was 8 years with 19(79.2%)of the study subjects being males. There were 3 maleneonatal tetanus cases with 2 deaths. From post-neonatal cases,only 8(38.1%) were fully vaccinated for infant Expanded Period ofImmunization (EPI). Booster vaccination with TT (tetanus toxoid)was only given to 5(29.4%) of discharged patients. Trauma wascommon in above 5 years of age and documented in 19(79.2%) ofpatients. All tetanus cases were generalized type with mild,moderate and severe grades comprising 7(29.2%), 8(33.3%),7(29.2%) and 2(8.3%) respectively. Case fatality rate was 29.2% (7)with more deaths in higher grades. Respiratory failure 6(85.7%),and aspiration pneumonia 1(14.3%) were causes of death.CONCLUSION: In this study, case fatality rate was high. Hence,health promotion with scale-up of EPI for infant tetanusimmunization and large scale studies to provide support for boostervaccination schedules are recommended.