Dissertation (MSc Paediatric Nursing)Background: Urinary Tract Infection is a common disease among Under-five Children in Pemba. Early detection and efficient management is important to minimize the possibility of morbidity and unnecessary complications. Objective: The objective of this study was to evaluate the Effectiveness of Empirical Diagnosis Approach for Urinary Tract Infection using Etiological and Antimicrobial Tests among Under-five Children in Pemba. Methods: A cross-sectional hospital-based design was used. Two district hospitals, namely Chake Chake and Wete, and two healthcare centres; Micheweni and Vitongoji were purposively sampled because of the high outpatient attendance. Participants were obtained by the means of the lottery method. The study included Children of 12-59 Months with an empirical diagnosis of Urinary Tract Infection from June-July 2020. Data were analysed through Statistical Package for Social Science. A Chi square test was used to find the relationship between categorical variables. Logistic regression was performed to determine the association between predictors and Positive Urine. Urine specimens was sent to a laboratory for Culture after being collected and was refrigerated when transportation delayed for more than two hours. A well-mixed sample of urine was inoculated on Cysteine Lactose Electrolyte Deficiency agar using a sterile standardized loop. The susceptibility tests were done using the recommended antimicrobial agents following the procedures for antibiotic susceptibility testing. Results: Out of 239 Children enrolled in the study, 22 (9%) had Urinary Tract Infection by positive Culture The commonest isolate was E-Coli which had shown resistant to Co-trimoxazole, Amoxacillin and Ampiclox. Temperature ≥37.5℃, Diarrhea and the Positive Leucocyte are the Predictors of Positive Urine Culture. Conclusion: The Prevalence of Urinary Tract Infection is 9% among Under-five Children attending at Paediatric Outpatient Clinics in Pemba. Gram negative bacteria were the most common isolated, E-coli being the majority of the isolate which had shown resistant to Co-trimoxazole, Amoxacillin and Ampiclox. Temperature ≥ 37.5℃, Diarrhea and Positive Leucocyte are the Predictors of Positive Urine Culture among Under-five Children.