Background:Atopic dermatitis (AD) is a prevalent chronic inflammatory skin condition in children, characterized by pruritus, erythema, and relapsing eczematous lesions. Despite its rising incidence in India, regional data on the clinical spectrum in eastern Bihar remains sparse. This study aimed to assess the clinical patterns, severity, and common triggers of AD in the pediatric population at a tertiary care center. Materials and Methods:A hospital-based cross-sectional study was conducted over 12 months at the dermatology &pediatrics outpatient department of a tertiary care hospital in eastern Bihar. A total of 180 children aged 6 months to 14 years clinically diagnosed with AD based on Hanifin and Rajka criteria were included. Detailed history, clinical examination, and scoring using the SCORAD (Scoring Atopic Dermatitis) index were recorded. Data were analyzed using SPSS version 25.0.Results:Out of 180 children, 98 (54.4%) were male and 82 (45.6%) were female. The most affected age group was 1–5 years (41.1%), followed by 6–10 years (35.0%). Common clinical features included pruritus (96.6%), xerosis (84.4%), and flexural eczema (62.8%). Mild, moderate, and severe AD were noted in 36.1%, 48.9%, and 15.0% respectively based on SCORAD scoring. Personal or family history of atopy was observed in 64.4% of patients. Common triggers included seasonal variation (51.7%), woolen clothing (28.9%), and food allergens (20.6%).Conclusion:Atopic dermatitis is a significant dermatologic concern in children of eastern Bihar, with predominant involvement in early childhood and a considerable burden of moderate-to-severe cases. Early recognition, avoidance of triggers, and parental education are essential for long-term disease control.