Hematological abnormalities have been documented are the most common cause of mortality and morbidity in HIV patients. Globally there were 36.7 million adult and children estimated to be living with HIV by 2015.In Eastern and Southern Africa in 2015 there were 19 million people living with HIV, and there were 56,000 new infected children. Hematological abnormalities such as anemia, neutropenia and thrombocytopenia occurred in HIV infected children were among clinical problems frequently reported in early years of acquired immune deficiency syndrome.. Aim: To determine the prevalence of hematological abnormalities and associated risk factors in HIV children less than 18 years receiving care at KCMC hospital. Methods: This will be hospital based cross sectional studywhich will be done from September 2016 to May 2017. A total of 265 children will be recruited from the Child Centered Family Care Clinic (CCFCC), data will be collected using questionnaire and laboratory data sheets. Social demographic, nutritional status and ARV drug history will be recorded. Venous blood 5 mills will be collected for hematological workup and for CD4 count workup by flow cytometry and viral load workup. Data will be coded and entered using SPSS, then will be summarized using frequency tables and graphs.Odds ratio and 95% confident interval will be estimated with p<0.05 judged as statistically significant. Ethical clearance will be obtained from the KCMU college research ethics committee and signed consent will be obtained from parent/ guardian prior to the recruitment into the study. Significance: We expect the findings from this study will help plan for management and treatment monitoring in children at risk and will be used as background information for future studies.