BACKGROUNDTyphoid fever in children is a common childhood infection in both urban and rural regions in tropical countries. Clinical presentation is varied and overlaps many other acute febrile illness. MATERIALS AND METHODSStudy was a prospective descriptive study. The study was conducted in Institute of Child Health and Hospital for Children, Egmore, Chennai, Tamilnadu during the period of April 2013 to November 2015. Children aged 3-12 years with fever more than 5 days with no obvious focus of infection. Coated tongue, abdominal distension, toxic look, constipation or loose stools, hepatomegaly, splenomegaly, relative bradycardia was included. Children immunised with typhoid vaccine, children already on antibiotics, and children with documented typhoid fever in the past 8 weeks were excluded. It was aimed to analyse the clinical presentation and to compare the Typhidot test and Widal test with the culture positivity in children with typhoid fever. RESULTS167 children fitted into the inclusion criteria, of which 26 (15.6%) children were culture positive. 52 (31.1%) children were Widal positive, 49 (29.3%) were Typhidot test positive. Fever with anorexia was the common symptoms, and toxic look, coated tongue was the common signs in our study group. CONCLUSIONSBlood culture for typhoid fever is the gold standard, but is time consuming. In our study, we conclude that Typhidot shows high sensitivity and low specificity with higher negative predictive value when compared to Widal test. KEYWORDSTyphoid fever, Typhidot Test, Widal Test. Since the clinical features of the common infections like malaria, dengue, typhoid, leptospirosis and scrub typhus are very similar it is difficult for the treating physician to diagnose typhoid fever based on clinical features. (1,2,3) It is then mandatory to have a very valid diagnostic test with good sensitivity and specificity for an earlier diagnosis in children with acute febrile illness. (4,5) With increasing use of antibiotics, the clinical presentation is nonspecific and difficult to diagnose based on clinical features in children. HOW TO CITE THIS ARTICLE: