Dissertation (MMED General Surgery)Children with surgical needs represent a high burden of disease, and lack of access to surgical care continues to threaten the health of millions of children worldwide and limit economic growth and development. Despite these outstanding efforts, failure to notice the need for surgical care for children continues within the global health agenda. A Hospital-based descriptive cross-sectional study in determining the Predictors of Poor Outcome in Emergency Pediatric Gastrointestinal Surgeries at University of Dodoma Affiliated Teaching Hospitals among 50 patients who underwent emergency gastrointestinal surgeries for different indication is harnessed. A convenient sampling technique was used to recruit study participants. The study duration was from January to May 2020. The performance of statistical analysis using SPSS, version 20.0 (IBM Inc., Chicago). Overall, respondents were 50 with the majority 17 (34.0%) were between 72-120 months while the minority 7 (14.0%) between 12-60, the mean was 7.50 ±4.092 (0.06 -180). Majority 26 (52.0%) were girls. The mean hospital stay was 8.12±5.885 (2-22) days, with the majority having a stay of between 8 – 13 days in 22 (44%) of the children. The age of study participants is significant in association with poor outcome of emergency pediatric gastrointestinal surgery (AOR=4.333, 95% CI=1.201-5.636, p=0.025), those who did not have a nasogastric tube were twenty-three times more likely to end up with poor outcome after emergency pediatric gastrointestinal surgery compared to their counterparts (AOR= 23.264, 95% CI=2.135-25.349, p=0.010). After twelve hours after admission, those who had surgical intervention were six times more likely to have poor outcomes than their counterparts below twelve hours post-admission (AOR= 6.068, 95% CI=1.565-23.531, p=0.009). Participants delayed Diagnostic and therapeutic intervention in this study led to the late presentation of the disease, lack of diagnostic and therapeutic facilities in non-referral centers, scarcity of trained personnel, in this case, pediatric surgeon availability and poor referral system are among the hallmarks of the disease leading up to a series of complications following treatment.