Aims & Objectives: To describe the epidemiology, therapeutic management and outcomes of children admitted to pediatric ICU (PICU) for acute respiratory failure (ARF) in a contemporary multinational PICU cohort. Methods: Retrospective analysis using prospectively collected clinical data within the LARed Network ARF clinical registry (35 hospitals, 8 Latin-American countries). We analyzed all PICU encounters for ARF that included any respiratory support from May 2017 to October 2019. Demographics, comorbidities, clinical data (including retrieval support and admission severity scores), etiology, PICU respiratory support, adjuvant therapies, and outcomes were described and expressed as median (interquartile percentiles) or relative (percentage) frequencies. Results: Final analysis included 5297 PICU admissions. The main findings are presented in the table. The median age was 5 months (2, 14), 58.1% were males and Bronchiolitis was the most common diagnosis (50.2%) with RSV the most frequent etiology (40.0%). Noninvasive ventilation (NIMV) was the maximal respiratory support in almost 2/3 of encounters from the cohort (61.8%), being high flow nasal cannula (HFNC) and bilevel positive ventilation (BiPAP) the 2 most commonly used techniques. NIMV related complications were low whereas Invasive MV related complications were 21.6%. Although global mortality was low (1.2%), we detected 3.0% of new morbidities at PICU discharge (> 3 change in Functional Status Scale).Conclusions: We present contemporary relevant clinical data regarding ARF epidemiology and patterns of care across Latin-American PICUs. These data provide benchmarks for hospitals to identify current regional practices, assess their performance and guide quality improvement initiatives.