Background: A reliable indicator of children's death is the Pediatric Risk of death (PRISM) score. Outside of America and Europe, there is relatively little information available about the predictive validity of the PRISM score, particularly in developing nations. Aim: Detecting the role of using (PRISM) score, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in prediction of morbidity and mortality in the pediatric intensive care unit to improve the quality of care. Patients and methods: A cross-section study was done among children in the pediatric intensive care unit of Suez Canal University Hospital. Results: The study included 153 pediatric patients. The average age was 3.61 years, with 56.9% of them being infants. 62.1% were discharged without morbidity ,8.5% were discharged with morbidity and 29.4% died. The mean PRISM score for those patients who were discharged without morbidity and those died were 8.0 ± 6.44 and 19.04 ± 10.32 respectively. The length of hospital stay, readmission, mechanical ventilation, sedative and vasoactive drug use, nosocomial infection, feeding, blood transfusion, systolic blood pressure, temperature, mental status, pupillary reflex, and PT/PTT all had a statistically significant association with outcome among admitted patients (P<0.005). Furthermore, the PRISM score was shown to have a statistically significant association with mortality outcomes but there was no statistically significant association with morbidity outcomes. Finally, there was no statistically significant association between PLR and NLR as risk factors with morbidity and mortality outcomes. Conclusion: The PRISM score demonstrated good discriminatory capacity and calibration, making it a valuable tool for determining prognosis in pediatric patients admitted to pediatric intensive care unit. In contrast, NLR and PLR were insignificant in determining patient outcomes.