Background: The clinical and hematological parameters of children with dengue during an outbreak in a non-endemic region have not been well described. To delineate the clinical profile of pediatric cases from a tertiary care center located in a non-endemic zone (Tangail district) in Bangladesh was the objective of the study. Methods: A cross-sectional observational study was conducted in the Department of Pediatrics of a 250-bed general hospital in Tangail, Bangladesh, between June 2019 to September 2019. Data collection was done using a pre-structured case record form. All patients underwent detailed history taking, physical examination, and hematological profiling. A total of 123 confirmed dengue cases were analyzed. Results: The average age of patients was 7.3±4.1 (SD) years, with nearly two-thirds being male (61.8%) and the majority living in rural areas (76.4%). Fever (100%), body ache (57.7%), headache (56.9%), and rash (55.3%) were the four common clinical manifestations. NS1 antigen and anti-dengue IgM antibody tests were positive in 86% (102 out of 119) and 37.7% (20 out of 53) of cases, respectively. Thrombocytopenia was present in 42% of cases. The majority of the cases had dengue fever (73.2%), and the remaining cases were either dengue hemorrhagic fever or dengue shock syndrome (26.8%). Clinical and hematological parameters varied with the type of dengue. Particularly, rash (p = <0.001), bleeding manifestation (p = <0.001), vomiting (p = 0.012), hypotension (p = 0.018), pleural effusion (p = 0.018), ascites (p = 0.018), hepatomegaly (p = <0.001) and low platelet count (<150 x 103cells/μL) (p = 0.038) were significantly more common among dengue hemorrhagic fever or dengue shock syndrome cases. Conclusions: The present study documented the clinical features of dengue in a pediatric group of patients from a non-endemic zone of Bangladesh. This vulnerable patient group requires earlier identification and keen attention during management. Author summary: Bangladesh saw an increasing frequency of dengue outbreaks over the last two decades. Most of the time, it was confined to large cities endemic to the disease. However, in 2019 a massive dengue outbreak occurred in the country, which spread from endemic to non-endemic regions of the country. The present study documented clinical and hematological profiles of 123 children with dengue who got admitted between June 2019 to September 2019 to a 250-bed general hospital in Tangail, a non-endemic region. Patients had an average age of just over seven years, and nearly two-thirds were male. More than one-quarter of patients had dengue fever with bleeding manifestation (dengue hemorrhagic fever). Two of the children suffered from dengue shock syndrome. Fever, body ache, headache, and rash were predominant clinical features. Thrombocytopenia was present in two-fifth of the cases. The presence of dengue in a non-endemic zone warrants further epidemiological, entomological, and environmental research in the area. [ABSTRACT FROM AUTHOR]