Background: Acute Kidney Injury (AKI) is on the rise among critically ill children. Sepsis is one among the common causes that predisposed to AKI. Early identification and timely intervention of AKI in sepsis children is the need of the hour to reduce the morbidity and mortality. Microalbuminuria has been shown to predict organ failure early in the course. This study intends to evaluate protein/creatinine ratio as a predictor for development of acute kidney injury in critically ill septic children. Methodology: A prospective observational study conducted at a tertiary care centre, Tamil Nadu over one year. AKI was defined by AKIN criteria. Baseline details were collected and serial serum creatinine levels were done. Urine spot protein creatinine ratio was done on day 2 of PICU admission and followed up for development of AKI. Statistical analyses were done using SPSS19. Results: A total of 93 children were included of which 54 (58.1%) were boys and 39 (41.9%) were girls. The incidence of Acute Kidney Injury among the sepsis children was 39.8%. Microalbuminuria was present in 78.4% children with AKI. The mean protein to creatinine ratio in AKI group was 39.76 ± 13.3.Protein:creatinine ratio of >30 predicted the development of AKI in sepsis children with a sensitivity of 85.4%, specificity of 88%, positive predictive value of 81.6% , negative predictive value of 87.1%and an AUC of 0.81 (95% CI 0.72 – 0.90). Conclusion: Urine protein:creatinine ratio may be included as a part of a routine screening tool, in children with sepsis, to risk stratify those patients who are at increased risk of AKI.