Background: Ascites are pathological conditions characterized by the accumulation of fluids in the peritoneal cavity. Ascites are among the most common complications of different diseases in pediatrics, such as renal diseases, cardiac diseases, and hepatic diseases. The pediatric group is considered a vulnerable category needing special care, so assessing the management of ascites in pediatrics needs to be addressed. Aim: The study was conducted to assess ascites' management in pediatrics in Jafar Ibn Auf pediatric hospital. Methods: A descriptive retrospective study was conducted at Jafar Ibn Auf pediatric hospital, Khartoum, Sudan. All medical files of pediatrics with ascites from 1 month to 18 years old during the period between 2017-2020 were included. Data were collected from file records using a predesigned data collection sheet and analyzed using the statistical package for the social sciences (SPSS) version 23. Results: A total of 143 medical records were included in this study. The majority of the group were males. The most affected patients were within the age group of ˂ 6 years old. Grade I was the most common presentation. Hepatic diseases and gastrointestinal diseases were the main etiological factors for ascites and represented in 62.2% and 15.4%, respectively. Regarding ascites management, the most frequent method of managing ascites used was medications with liver support. Moreover, 63.2% of the patients were treated by combining spironolactone with furosemide. Out of the 143 patients, 92.3% of patients were discharged from the hospital, while the remaining were referred to other hospitals. Statistically, there was a strong association between the grade of ascites, management of ascites, and the patient's discharge (P = 0.001). Conclusion: The results showed that liver diseases were the most common etiological cause of ascites in pediatrics. The majority of patients were treated properly managed in term of dose, and the combination of spironolactone and furosemide were the most frequently used medications in this study. The proper diagnosis and appropriate management of ascites is critical to prevent related morbidity and mortality in pediatrics.