Introduction: Febrile Neutropenia (FN) is a potentially life threatening complication in pediatric cancer patients. There is paucity of data on the trends of FN hospitalization, length of stay (LOS) and cost of hospitalization among pediatric cancer patients in the United States. We used National Inpatient Sample (NIS) database from year 2009 to 2014 to analyse these trends. Methods: We queried NIS database from 2009-2014 and included hospitalization for patients ≤ 19 years of age. To prevent overestimation, we excluded transfers. Cases with Febrile Neutropenia (FN) were identified using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes for Fever (780.6) and Neutropenia (288.0, 284.1 and 288.50). Cancer diagnosis and infections among patients with FN were identified using Healthcare Cost and Utilization Project (HCUP) Clinical Classification Software (CCS) codes. For trend analysis, the ÷2 test for trend for proportions was used using the Cochrane Armitage test via the “trend” command in Statistical Analysis Software (SAS). Multivariate odds ratios were calculated. P-value for < 0.05 was considered as significant. Weights provided by NIS were used to generate national estimates. All analysis was performed with weighted estimated. Cost was adjusted for inflation. This study involved subjects from de-identified database, so it was exempted from Institutional Review Board (IRB) approval. Result: From 2009 to 2014 there were 150,800,000 pediatric hospitalizations, of which 1,266,886 FN hospitalizations were identified. Trends of FN increased from 71 per 100,000 hospitalizations in 2009 to 95 per 100,000 hospitalizations in 2014 (p-value: < 0.0001). Overall median LOS was 4 days. LOS remained stable at 5 days in 2009 and 2014 (p-value: 0.0002). Overall median cost of hospitalization was $9740. Inflation adjusted cost increased from $9422 in 2009 to $10427 (p-value: < 0.0001). Mortality trend is decreasing from 1% in 2009 to 0.64% in 2014 (p-value: < 0.0001). On multivariate analysis, Odds of having LOS > 3 were significantly higher among patients with sepsis (Odds Ratio [OR] 7.81 95% Confidence Interval [CI] 7.20-8.47), meningitis (OR 6.84 95% CI 3.94-11.87) and pneumonia (OR 3.68 95% CI 3.38-4.02) after adjusting for potential confounders. Odds of having cost of hospitalization greater than median were significantly higher among patients with Sepsis (OR 5.00 95% CI 4.72-5.30), meningitis (OR 3.15 95% CI 2.18 -4.55) and pneumonia (OR 3.18 95% CI 2.96-3.42) after adjusting for potential confounders. Conclusion: Our analysis shows increasing trends of febrile neutropenia admissions. However, the mortality trend has decreased over time. LOS have been relatively stable but inflation adjusted cost of hospitalization have been increasing over study period. Presence of sepsis, meningitis and pneumonia may be associated with higher odds of having longer LOS and higher cost of hospitalization.