Objective: To determine the etiological profile of pancytopenia in pediatric patients in India. Material and methods: Medical records review of a 5-year period between 1st September 1997 and 31st August 2002. Clinical and hematological data of all patients with pancytopenia (hemoglobin [Hb] =10 g/dL, TLC =4 × 109/L, platelet count =150 × 109/L) at presentation were analyzed. Patients on cytotoxic chemotherapy, those developing pancytopenia during hospital stay, patients referred from other centers with hematological malignancies and neonates were excluded. Results: Forty-two children (mean age 8.26 years, range 8.5 months to 13 years, M:F : 1:0.8) were included. Megaloblastic anemia, aplastic anemia and infections were commonest causes, being responsible for 25%, 19.6% and 32.1% of the cases, respectively. Bone-marrow aspiration (BMA) was helpful in reaching a definitive diagnosis in 92.8% of those in whom sufficient marrow tissue was retrieved for analysis. Aplastic anemia was the commonest reason for failure of BMA in providing a diagnosis. Conclusions: Majority (almost 60%) of the causes of pancytopenia among pediatric patients in this region are easily treatable. There is a need to be aware of such conditions and appropriate investigative modalities should be undertaken for the same.