Drugs have to be safe, effective and be used nationally and may require a special concern due to their unwanted side effects. Safely and effective use of drugs depend on prescribing pattern. The aim of the study was to assess the drug prescribing practice in pediatrics ward of St. Paul Specialized Hospital in Addis Ababa, Ethiopia. A retrospective study had been conducted from January 20 to February 15, 2009. Structured data collection formats were used to obtain data from patient records using stratified and random sampling techniques. Data were analyzed using SPSS for Windows version 16.0. Sums of 384 patient cards were included to the study in which 468 drugs were prescribed. Cotrimoxazole (18.87%), amoxicillin (14.50%), and paracetamol (10.4%) were the most commonly prescribed medications. Average number of drugs per encounter was 1.22. About 71.35%, 59.4%, 45.73% and 15.17% of drugs were prescribed with correct indication, frequency, dosage and duration respectively. There has been an inappropriate use of drugs in the hospital. Many drugs were prescribed without information regarding dosage, frequency and duration of treatment. Pharmacy professionals and physicians should check the completeness of patient cards and prescriptions to promote rational use of medications.