Background: Typhoid fever, a severe febrile illness caused primarily by a gram-negative bacillus Salmonella typhi, has continued to be a public health problem in many developing countries. Typhoid infection is generally transmitted by faeco-oral route and may occasionally lead to an epidemic, particularly in areas with poor sanitation and limited availability of clean and portable water. It is a global health problem that can have a devastating impact on resource poor countries like Tanzania. Understanding the prevalence and outcomes of the disease among hospitalized children will add information for planning on better management of patients and infection control strategy Objectives: To determine the prevalence and outcome of typhoid fever among children admitted at Kilimanjaro Christian Medical Centre in Moshi municipal from January 2014 to December 2015. Methodology: This was a hospital based descriptive cross sectional study which was done at KCMC hospital. Hospital files of all children with diagnosis of Typhoid fever, admitted from January 2014 to December 2015 in Paediatric department were reviewed. Data collection sheet was used to collect key information during the review on the files medical history and social demographic characteristic, common clinical presentations were extracted from medical record files including information on outcomes and status on discharge. SPSS version 20 was used to analyze the data collected. Results During the study period a total of 3797 patients were admitted at paediatric ward of KCMC ,136 children were diagnosed with Gastro-intestinal illness of whom 38(1%), were diagnosed with typhoid fever clinically. 23 (60.5%) were males with a median age of 3 years (range from 1 to 12 years). Majority of patients presented with fever 34(89.5%) and vomiting 32(84.2%). Children were more likely to have Malaria (15.8%), UTI (15.8%). The most common prescribed treatment was ampicillin (47.4%), and ceftriaxone(47.4%).Seventy one patients were from Moshi municipal and of the 19 who had laboratory test 12 (63.16%) had positive widal test. Conclusion From these study findings, the prevalence shows that typhoid fever is still a health problem making a significant cause of admissions among children. The clinical presentations of typhoid fever are non-specific for most diseases acquired by children and therefore typhoid fever should x be considered in children having these symptoms. The study also shows that severity of the disease increases when a child is co-infected by other diseases therefore proper management of such cases is highly required. The prognosis and outcome of typhoid fever is good if the child is well managed at earlier stages of the disease.