BACKGROUND: Pediatric cancer patients are considered one of vulnerable group for covid-19 infections and its associated complication. We assessed in this study, covid-19 prevalence and implications in pediatric cancer patients of North-East India METHODS: A total of sixty three pediatric cancer patients were tested for covid-19 by RT-PCR between July 2020 to September 2020. All the patients received chemotherapy as per their cancer types. Patients within age group one year to eighteen years were included. Retrospectively medical records of pediatric cancer patients were analyzed for clinical outcome between COVID positive and negative group. RESULTS: Among sixty three patient, 19(30%) were found positive for COVID-19. Among COVID-19 positive patients, fourteen patients have hematological malignancies. Fever was the main presenting symptom along with cough and sore throat there were no statistically significant association observed between COVID-19 positive and negative group for gender, cancer type, total WBC count and absolute neutrophil count. Survival outcome has shown statistically significant association (p=0.0065) between COVID-19 positive and negative pediatric cancer patients. Four deaths occurred in COVID-19 positive patients but there was no death in COVID-19 negative patients. Statistically significant association was also observed between COVID-19 positivity in patients being symptomatic (p=0.0001). CONCLUSION: We conclude from our present study that among pediatric cancer patients of North-East India, COVID-19 positivity was significantly high in symptomatic patients compared to asymptomatic. Among COVID-19 positive pediatric cancer patients risk of death was significantly higher compared to COVID-19 negative patients.