Several studies have reported the prevalence and incidence of febrile seizure (FS) among children in the USA and other countries. However, recent trends in FS among hospitalized children, hospital course, and risk factors for its severity remain unknown at a national level in the USA. Method: Hospital discharge records of patients with FS aged <6 years were obtained for the years 2003, 2006, 2009, and 2012 from the Kid's Inpatient Database. Data were weighted to estimate the annual hospitalization rates with respect to gender and race/ethnicity in the United States. Multivariable logistic regression was conducted to ascertain factors associated with FS severity. Results: A decreasing trend in total annual hospitalization rates due to FS was observed, ranging from 59.0 per 100,000 children in 2003 to 40.8 per 100,000 children in 2012 (p < 0.001). Winter predominance of hospitalizations was observed (p = 0.001). Hispanic children and children admitted to hospitals in northeast region were less likely to be severely affected. Age, gender, health insurance status, and household income level were not associated with FS severity. Conclusions: Total hospitalization rates due FS is decreasing, and race/ethnicity and geographic locations of the patients were associated with FS severity.