Background;-Global report by WHO in 2014, there were an estimated 9.6 million new TB cases: 5.4 million among men, 3.2 million among women and 1.0 million among children. There were also 1.5 million TB deaths (1.1 million among HIV-negative people and 0.4 million among HIV-positive people), of which approximately 890 000 were men, 480 000were women and 140 000 were childrens. Tanzania as put a lot of effort to reduce child morbidity and mortality caused by tuberculosis by providing free treatment to all case of TB in children and adults. But according to Tanzania national tuberculosis and leprosy program, the magnitude of TB diseases among children in Tanzania is difficult to ascertain due to challenges in diagnosis and reporting .However, data from the NTLP to past eight years show that pediatric cases constitute on average about 8% of TB cases notified annually. . Objectives; To identify the risk factor and treatment outcome of TB treatment among children’s below 15 years of age attending Kibong’oto hospital. Methodology; this is descriptive cross section hospital based study was conducted at Kibongoto hospital among children’s below 15 years of aged from January 2014 up to December 2015 to assess the risk factor and treatment outcome of TB treatment at kibongoto hospital. Data was collected from the file of children who were admitted during that period. . Data entry and analysis was performed using SPSS version 20. Result: The overall result show that female children were more affected by pulmonary tuberculosis than male children’s, 51.4 %( 18) out of 35 children’s with pulmonary tuberculosis. The burden of tuberculosis is contributed by HIV infection. Were 94% of all children was tested for HIV status, and 22% was tested positive HIV and 77% was HIV negative. This show that the burden of PTB was high among newly diagnosed HIV infected children. There were 2 death of children’s occurring after anti-TB drugs initiation and all death were HIV positive children’s. Conclusion: Pediatric TB cases at Kibongoto hospital which is largest national hospital for treatment of TB in Tanzania it show that PTB is more common among children below 15 year than extra pulmonary tuberculosis. Also severe case was found in those children’s patient with risk factor for tuberculosis like HIV positive, contact history of TB in family member, malnutrion’s. Thus more plans for prevention and health care in pediatric TB should focus on PTB and EPTB, HIV/TB. Also in children patient aged less than 15 year, because transmission of TB in children is reflection of ongoing transmission of MTB in a community