Introduction Mortality risk scoring systems have been widely used in modern intensive care unit. It isrnconsidered as important measures for quality assessments, controlling for severity of illness in clinicalrnstudies and studies of resource utilization and management.rnObjective The aim of this study was to determine pediatrics index of mortality 2 (pim2) scoring forrnPediatric intensive care unit (PICU) admitted to Tikur Anbesa specialized hospital (TASH) patients, andrnto evaluate its service with the standards.rnMethodology Descriptive cross sectional study with prospective data collection. All patients admitted tornPICU from April, 1-September, 20-2017 were included. Pretested questioner which includesrndemographics, diagnoses at admission, and duration of intensive care unit stay, PIM2 score and outcomernwas used. The data was entered and analyzed using SPSS version 20. The ratio of observed to predictedrnmortality using Standardized mortality ratio (SMR) was calculated for the group of patients by using chirnsquare.rnResults The study included 82 patients. The main causes of admission surgical (34.1%), neurologyrn(17.1%) and cardiac diseases (13.1%) Patients stay in PICU ranged from (1 â€“ 120) days with a medianrn4(interquartile range (IQ): 1-120) days. Fourthy four (53.66%) needed mechanical ventilator within 1rnhour of admission from this 23(52.3%) of them died which contributed 69.7%of the total death. The meanrnpredicted mortality by pim2 was 13.1[95%CI: 15.26-26.86] and the observed mortality was 40.2%rnmaking a SMR 3.1.rnConclusion and recommendation In our study PIM2 scoring didnâ€™t discriminate between died andrnimproved in PICU case mix patients at TASH so it is better to do another scoring system with itsrnvalidation study.