Objectives: To determine the clinical features, etiological and hematological spectrum of pancytopenia in children between the age of 1month to 18 years from Kalaburagi, Karnataka India. Materials and methods: A Prospective observational study, was conducted at the Department of Pediatrics, Gulbarga Institute of medical Sciences, Kalaburagi, Karnataka from 1st August 2021 to 31st July 2022(12 months). This study included 60 patients between the age of one month till 18 years with pancytopenia. Study participants were assessed for various parameters including their demographic details, clinical features, immunization history, and nature of the disorder. The prevalence of various etiologies (nutritional, neoplastic, infectious, autoimmune, and others) of pancytopenia was ascertained. Results: Of the 60 patients, 26(43.33%) were males and 34 (56.66%) were females with a mean age of 69.47 ± 7.12 months. Fever was present in 71.66%, arthralgias in 55%, weight loss in 15%, and failure to thrive in 18.33% of patients. The bone marrow examination revealed aplastic changes in 36 (37.50%), hyperplastic changes in 21 (21.87%), and normal cellularity in 40.62% of patients. Pancytopenicanemia was the most common nutritional cause of pancytopenia present in 21.66% of cases. Acute lymphoblastic leukemia (ALL) was the most prevalent neoplastic etiology present in 8.33% of patients. Aplastic anemia, miliary tuberculosis, parvovirus B19, systemic lupus erythematous and hemolytic anemia were other notable etiologies. Conclusion: Majority of the causes of pancytopenia among pediatric patients in our region are preventable. There is a need to be aware of such conditions and appropriate investigative modalities should be undertaken for the same.