Aims & Objectives: The objective is to know the prevalence of metapneumovirus infection and its association with rainfall and clinical outcomes in children living at moderate altitude above sea level. Methods: A cross-sectional study was carried out on patients seen at a university hospital in Bogotá, Colombia between October 2015 and December 2017 in a city at a moderate altitude above sea level. Children with acute respiratory infections who had had a multiplex RT-PCR assay were selected. The prevalence of HMPV infection, its clinical outcomes and its relationship to rainfall were evaluated. Results: Out of a total of 14,760 discharged patients, multiplex RT-PCR was performed on 502 and a virus was detected in 420 children with acute respiratory infection (ARI). Median age of 21 months (IQR 7-60), proportion of males and females (56.4% and 43.6% respectively) and 5.2% (CI 95% 3.3% - 7.8%) prevalence of HMPV infection. HMPV infection group showed a greater frequency of viral coinfection (22.7% vs 14% P=0.03) compared with ARI by other viruses. The rate of bacterial coinfection (P=0.31), comorbidities (p=0.75), length of hospital stay (P=0.42), mechanical ventilation (P=0.75) and mortality (P=0.22) were similar for HMPV and other viral infections. A moderate correlation was established between HMPV infection and rainfall peaks (Spearman´s Rho 0.44 p=0.02). Conclusions: Human metapneumovirus was the fifth most frequently isolated virus in children with ARI, had similar clinical behavior and severity to other viruses but a higher rate of viral coinfection. Its peaks seem to correlate to rainy seasons.