Background:Acute flaccid paralysis (AFP) in children poses a complex diagnostic challenge with diverse etiologies. This study aims to comprehensively analyse the etiology, clinical manifestations, and short-term outcomes of AFP.Materials and Methods:A retrospective observational study was conducted at Government Rajaji Hospital, Madurai, Tamil Nadu spanning from January 2021 to August 2022. The study included children under 15 years with AFP. Detailed clinical evaluations and scoring systems were employed to assess short-term outcomes.Result:Of the 50 children studied, Guillain-Barré Syndrome (GBS) emerged as the predominant cause (22%), followed by stroke (16%) and traumatic neuritis (16%). Prognostic indicators, including the Ordinal Disability Score (ODS) and Arm Function Score (AFS), demonstrated their utility in predicting short-term outcomes. Early hospitalization within 5 days significantly improved survival rates (87.5%). Conclusion:This study provides crucial insights into the multifaceted nature of AFP, emphasizing the importance of prompt diagnosis, targeted interventions, and ongoing polio surveillance.