Introduction: Pediatric solid tumors are a significant health challenge worldwide. It is more worsened in low- and middle-income countries like Ethiopia where there is deprived health care infrastructure and limited treatment modalities. This study aims to understand the epidemiological characteristics, pattern of these tumors and short-term treatment outcome which is crucial to provide timely and appropriate treatment to patients. Methods: a retrospective study of 2 year and 8 months period was conducted among all pediatric solid tumor children below age of 15 admitted at St Paul’s Hospital Millennium Medical College Hemato- Oncology unit. Data from the patient charts were entered and analyzed using SPSS version 29. Result: There are a total of 173 pediatric solid tumor patients over study period. 22.6% patients were seen on first year, 34.6% seen on second year and 42.8 % patient seen on last 8 months of the study period. 56.1% of them were males. Most patients came from Oromia region. The most frequent solid tumors were retinoblastoma, Wilm’s tumor and Rhabdomyosarcoma. Out of these 86 patients are still on treatment, 23 patients went into complete remission, 4 relapse, 2 were defaulters (Skipping a scheduled visit during evaluation of more than 2 weeks or skipping a scheduled session of chemotherapy by more than the duration between chemo-sessions), 5 patients lost from follow- up , 21 died, 5 refered to other hospital , 10 left against medical advice. Conclusion: The study shows increasing childhood solid tumour cases over the years. A significant portion of patients achieved remission, while the majority are still undergoing treatment or follow-up care. There are a small percentage of relapse, defaulters and loss to follow-up with mortality rates were observed. Early detection strategies and community-based awareness programs aimed at promoting early presentation to healthcare facilities could potentially improve outcomes by facilitating timely diagnosis and intervention.