Background: The growing prevalence of antibiotic-resistant infections presents a significant challenge in the setting of sepsis management, especially within pediatric intensive care unit (PICU) work. Objective: To explore the association of culture sensitivity and antibiotic resistance in pediatric patients diagnosed with sepsis. Study Design: This is a retrospective observational analysis. Duration and Place of the Study: This study conducted over a one-year period from 1 st january 2023 to 30th December 2023, in the pediatric intensive care unit (PICU) at Saidu group Of Teaching hospital, Swat. Material and Methods: This study included 105 pediatric patients who were admitted to the PICU and had sepsis. Inclusion criteria: Patients aged 0-18 years old Clinical diagnosis of sepsis based on the international consensus criteria Data available for microbiological culture and antibiotic sensitivity data were included in study. Insufficient medical records Patients transferred to the PICU from another hospital and no prior microbiological data were excluded from study. Results: A total of 105 pediatric patients with sepsis confirmed were included in the study. Mean age of the patients 6.78 ± 5.50 years. Distribution of age was as follows 23.8 % were between 0-1 year, 28.6% from 2-5 years, 19.0% from 6-10 years and (28.6%) aged from 11-18 years respectively. The gender distribution was 55.2% male to 44.8% were female. Amongst 0-1 years, it was also higher at (60.0%, p=0.045), amongst 2-5-year-olds also had a rate of (60.0%, p=0.032) and among the group aged between 11 to 18 years (56.7%, p=0.048). Conclusion: Results from this study showed the crucial need for a culture sensitivity test when choosing appropriate antibiotic therapy in pediatric septic cases.