Background: Multidrug-resistant (MDR) infections are a significant challenge in pediatric intensive care units (PICUs), particularly in resource-limited settings. These infections lead to increased morbidity, mortality, and healthcare costs. Understanding the prevalence and risk factors associated with MDR infections in PICUs is essential for developing effective preventive strategies. Objective: This study aimed to determine the prevalence of MDR infections and identify associated risk factors across multiple PICUs in central India. Methods: A prospective multicentric observational study was conducted in three PICUs across central India over 12 months. All patients admitted to the PICUs for more than 48 hours were included. Data on demographic characteristics, underlying medical conditions, invasive procedures, antibiotic usage, and the occurrence of MDR infections were collected. MDR pathogens were identified using standard microbiological methods. Logistic regression analysis was performed to identify independent risk factors associated with MDR infections.