BACKGROUND: In the absence of population based cancer registries, hospital records can only highlight the importance of collection and analysis of data to address the burden of cancer among children. For this purpose, a hospital-based registry’s pediatric cancer data (individuals aged 0-18 at diagnosis) from 2010 to 2019 was compiled and analyzed at AKUH in Karachi, Pakistan. METHODS: A paper-based system is used to record all interactions with patients at the hospital. A dedicated team of Cancer Registrars transcribe this data onto a US based registry software; CNExT. Registry data was extracted through software generated reports and compiled for analysis. RESULTS: The total number of children presented at our center was 2,694, out of which 1,673 were males while 1,021 were females. Top 5 sites were bone marrow (n=887), central nervous system (n=481), lymphoid tumors (n=294) bone (n=255) and soft tissues (n=145). All other sites contributed to 632 cases, 23.5% of the total patient population. Furthermore, 806 patients were aged 0-4, 627 were aged 5-9, 684 were aged 10-14 while 966 patients were 15-19 years old.. A consistent increase of 210% was noted during the 10-year period. CONCLUSION: Our database analysis shows that the top cancer sites are consistent with other databases around the world. Increase in numbers may reflect awareness and referral pattern emphasizing the need for capacity building at the national level to accommodate patients locally so families don’t have to travel over provincial and international borders to receive treatment.