Background and Aim: Positive Systemic inflammatory response syndrome (SIRS) with a high pediatric end-stage liver disease (PELD) score may indicate a poor prognosis for children with liver cirrhosis where early interventions could reduce mortality. Our objective was to determine, for the first time in Bangladesh, the relationship between SIRS and PELD score and the hospital prognosis of children with liver cirrhosis. Patients and Methods: This cross-sectional study was conducted between March 2018 and February 2019 at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, among admitted children admitted with liver cirrhosis between 1 month and 12 years of age. All participants were screened for SIRS, and PELD scores were calculated. Data were analyzed to find the relationships between SIRS and PELD scores and hospital outcomes. Results: A total of 53 patients were enrolled in this study with a mean age of 74.9 (± 55.8) months. Among them, 26 (49.1%) patients with positive SIRS. Wilson’s disease (49.1%) and biliary cirrhosis (35.8%) comprised most of the cases. Total 10 (18.9%) patients died during the hospital stay, and mortality was significantly higher among SIRS positive group (p=0.03). The area under the Receiver-Operator Characteristic (ROC) curve of positive SIRS and PELD was 0.691 and 0.602, respectively. A high PELD score (>24) was associated with an increased risk of death (odds ratio 2.294). Multivariate Logistic Regression analysis showed only SIRS positivity was independently associated with increased mortality (p<0.05). Conclusion: Positive SIRS and high PELD scores are correlated with increased hospital mortality in pediatric liver cirrhosis patients. Early interventions can deter their imminent death.