Background: Nephrotic syndrome is a common pediatric kidney disorder with a relapsing course, where corticosteroids remain the mainstay of treatment. However, prolonged steroid therapy is associated with significant adverse effects. This study aimed to assess the burden and pattern of steroid toxicity in children with steroid-sensitive nephrotic syndrome (SSNS). Methods: A cross sectional observational study was conducted in a pediatric nephrology outpatient clinic of a municipal teaching hospital in western India. Children below 12 years with SSNS, receiving oral steroids and followed over six months, were included. Patients were categorized as IRNS, FRNS, and SDNS. Steroid toxicity was assessed clinically, including cushingoid facies, growth parameters, blood pressure, BMI, ophthalmologic evaluation, and infections. Standard WHO and AAP guidelines were used for classification. Results: Among 27 children with SSNS, 16 (59.25%) developed steroid toxicity. The majority were males (81.25%), with 75% having disease onset before 3 years of age. SDNS was the most common subtype (37.5%), followed by equal distribution of IRNS and FRNS (31.25% each). Cushingoid facies was the most frequent toxicity (75%), followed by growth retardation (56.25%) and hypertension (56.25%). Obesity was observed in 37.5% and cataracts in 31% of cases, while infections were seen in 25%. Steroid toxicity was more common in children receiving therapy for more than 10 months, with growth retardation showing a significant association (p=0.048). Cataract (p=0.048) and hypertension (p=0.035) were significantly associated with type of nephrotic syndrome. No cases of fractures or mortality were observed. Conclusion: Steroid toxicity is common in children with SSNS, particularly with prolonged therapy. Early identification and regular monitoring are essential to reduce complications and improve outcomes