This study aimed to assess the predictive efficacy of dipstick urinalysis in detecting urinary tract infections (UTI) among febrile children under five years of age at the Federal Medical Centre, Owerri, Imo State, Nigeria. The research involved a hospital-based descriptive cross-sectional study, analyzing the diagnostic performance of nitrite and leucocyte esterase tests on urine dipsticks. The results revealed low sensitivity but high specificity for both tests, suggesting their potential role in excluding UTI. The findings emphasize the importance of combining dipstick urinalysis with urine culture for accurate diagnosis in febrile children. Keywords: Urinary tract infections, Dipstick urinalysis, Febrile children, Nitrite, Leucocyte esterase, Diagnostic efficacy, Nigeria