Background: Platelet transfusion is an essential supportive component of therntreatment of oncology patients with survival benefit. Platelet transfusion refractorinessrnis an important challenge in pediatric cancer patients who require repeatedrntransfusions. rnObjectives To assess platelet increment and refractoriness after platelet transfusion inrnpediatric cancer patients, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia rnMethods: In this study, 113 eligible patients were included and data was collected byrnoriented nurses and physicians using structured questionnaire. Data completenessrnassessment and coding was done and it was processed and analyzed by SPSS versionrn25 using frequency tables, Chi Square and Regression analysis tools. rn Result: In this study, 113 pediatric cancer patients were included. Most of thernpatients are in the age group of 5-10 years (46.9%) followed by under 5 years (43.4%).rnThe majority are male sex accounting for 57.5 %. There is a significant associationrnbetween platelet increment after transfusion with the type of cancer(p=0.001) andrnbeing on chemotherapy (p 0.018) on Chi square analysis. Regression analysis revealedrnnegative correlation between age of patient and platelet increment(p=0.14). There isrnalso significant association between splenomegaly and previous platelet transfusionrnwith platelet increment (p=0.003 for both). The incidence of platelet transfusionrnrefractoriness is 12.5%. rnConclusion: Based on the findings of this study, increment of platelet in pediatricrncancer patients in TASH is affected by age of patient, Type of cancer, Splenomegaly,rnPrevious platelet transfusion history and Chemotherapy. Platelet transfusionrnrefractoriness is seen in 12.5% of the patients. rnRecommendation rnWe recommend a larger-scale study with better organized methodology to bernconducted to draw more representative results.