Aim: This study aims to investigate the association between thrombocytosis and lower respiratory tract infections (LRTIs) in the pediatric population. The primary objective was to determine the prevalence of thrombocytosis in children diagnosed with LRTIs and to analyze the correlation between platelet counts and the severity of infection. Materials and Methods: A cross-sectional study design was employed, involving 100 pediatric patients aged 1 month to 12 years diagnosed with LRTIs. Participants were recruited from the pediatric outpatient and inpatient departments of a tertiary care hospital. Data were collected using a structured questionnaire covering demographic details, clinical history, and laboratory findings, including complete blood count (CBC) and platelet counts. Thrombocytosis was defined as a platelet count greater than 450,000/µL. The severity of LRTIs was assessed using clinical and radiological criteria. Results: The study revealed that 50% of children in the thrombocytosis group experienced moderate severity of LRTIs compared to 24% in the normal platelet count group, with a highly significant p-value of <0.001. Patients with thrombocytosis had a significantly higher mean platelet count of 510 ± 50 x10^3/µL compared to 300 ± 40 x10^3/µL in those with normal counts (p < 0.001). The duration of illness was also longer in the thrombocytosis group, with 50% experiencing symptoms lasting more than 7 days, compared to only 20% in the normal platelet count group (p = 0.02). Logistic regression analysis identified severe LRTI as a significant predictor of thrombocytosis (OR 2.35, 95% CI: 1.54-3.65, p < 0.001). Conclusion: The findings suggest a strong association between thrombocytosis and the severity of LRTIs in the pediatric population. Elevated platelet counts were linked to both increased severity of symptoms and prolonged duration of illness, highlighting the need to monitor platelet levels as part of clinical assessment in children with LRTIs.