Introduction: Acute onset hemiparesis is a common neurological problem among admitted children. This prospective observational study is planned to describe the etiological profile of hemiparesis in children.

Material and Methods: This prospective observational study was done from September 2017 to June 2018 at a tertiary care teaching hospital of northern India. Consecutive child of age between one month and 14 years, admitted with acute onset hemiparesis or developed hemiparesis during hospital stay were enrolled in the study. Data was collected into a predesigned proforma after obtaining consent.

Results: Sixty patients were enrolled out of which 36(60%) were male and 24(40%) were female. Average age of patients was 5.7 ± 3.5 years. Central nervous system infection (CNS) was the most common cause (61.7%) followed by the acute ischemic stroke (15%).  Intracranial bleeding, tumour and venous thrombosis were the other important causes of hemiparesis. Among CNS infections, acute encephalitis syndrome was found in 30% and tuberculous meningitis in 23% patients. Inflammatory granuloma (3%), meningococcal meningitis (1.6%) and rickettsial infections (1.6%) were other CNS infections identified.

Conclusion: This study shows that in Uttar Pradesh, India, CNS infection is the most common cause of acute onset hemiparesis in children.