OBJECTIVE: The primary objective was to determine the prevalence and characteristics associated with malpositioned temporary, non-tunneled central venous catheters (CVC) placed via the internal jugular (IJ) and subclavian (SC) veins in pediatric patients. DESIGN: Single center, retrospective cohort study. SETTING: Quaternary academic pediatric intensive care unit. PATIENTS: Children > 1 month to < 18 years who had a CVC placed between January 2014 to December 2018. INTERVENTIONS: None MEASUREMENTS AND MAIN RESULTS: The primary outcome was the CVC tip position located on the first post-procedural radiograph. CVC tip was defined as: “recommended” (tip location between the carina and 2 vertebral bodies inferior to the carina), “high” (tip location between 1 and 4 vertebral bodies superior to the carina), “low” (tip position 3 or more vertebral bodies inferior to the carina), and “other” (tip grossly malpositioned). 781 CVCs were included: 481 (61.6%) were in “recommended” position, 157 (20.1%) were “high”, 131 (16.8%) were “low”, and 12 (1.5%) were “other”. Multiple multinomial regression (referenced to “recommended” position) showed that left-sided catheters (adjusted OR 2.00, 95% CI 1.17–3.40) were associated with “high” CVC tip positions while weight ≥ 40 kg had decreased odds of having a “high” CVC tip compared to the reference (aOR 0.45, 95% CI 0.24 to 0.83). Further, weight category 20–40 kg (aOR 2.42, 95% CI 1.38–4.23) and females (aOR 1.51, 95% CI 1.01–2.26) were associated with “low” CVC tip positions. There was no difference in rates of central line associated blood stream infection, venous thromboembolism, or tissue plasminogen activator usage or dose between CVCs with tips outside and those within the recommended location. CONCLUSIONS: The prevalence of internal jugular and subclavian CVC tips outside of the recommended location were high. Left-sided catheters, patient weight, and sex were associated with malposition. Malpositioned catheters were not associated with increased harm.