Background: Febrile neutropenia is a serious and common complication in pediatric oncology. Kaiser Permanente Northern California (KPNC) hospitals use varying fever thresholds for admission criteria: the KP Oakland hospital employs a threshold of 101.5°F, while KP Roseville and KP Santa Clara use lower thresholds. This study aims to assess the potential risks associated with adopting a higher fever threshold, including bacteremia, pediatric intensive care unit (PICU) transfer, septic shock, and length of hospital stay. Procedure: This retrospective cohort study includes KPNC members aged 1-18 years with an oncologic diagnosis admitted to one of three KPNC hospitals with neutropenic fever between 2016 and 2022. Patients admitted with a fever ≥101.5°F (high-threshold group) were compared to those admitted with a fever <101.5°F (low-threshold group). Results: The study cohort included 183 patients with mean age of 8.2±5.4 years, 59.6% male. Of these, 73 (40%) were in the low-threshold group, and 110 (60%) in the high-threshold group. Overall, 24 (13.1%) patients developed bacteremia, and 24 (13.1%) required PICU transfer. Comparisons between the low- and high-threshold groups showed no statistically significant differences in rates of bacteremia (8.2% versus 16.4%, p=0.11), PICU transfer (12.3% versus 13.6%, p=0.80), septic shock (2.7% versus 4.6%, p=0.53), or length of hospital stay (4.4 [IQR 2.5-8.1] versus 4.2 [IQR 2.6-8.0] days, p=0.81). Conclusion: Future studies with larger sample sizes are needed to validate these findings. If confirmed, the results suggest using higher fever thresholds for febrile neutropenia hospital admissions may be safe and could reduce hospitalizations for some pediatric oncology patients.