BACKGROUND: Unanticipated admission to the pediatric intensive care unit (PICU) associated with anesthesia may serve as an outcome measure to evaluate the quality of anesthesia care and as education material for residency training. METHODS: We reviewed the unanticipated PICU admissions after anesthesia during 1 year period in order to analyze patient pattern, causes, and specific therapeutic interventions. We also determined whether there were any preventable anesthetic factors responsible for PICU admission. RESULTS: There were 640 admissions to PICU from operating theatres, with 8 unanticipated admissions. Age of the patients ranged from 4 months to 14 years. The unanticipated admissions were distributed to all of the surgical departments. Of 8 unanticipated admissions, only one was considered a preventable feature and had intensive care. CONCLUSIONS: The unanticipated admissions to PICU from the operation theatre were not associated with age or department of surgery. The majority of the causes of unanticipated admission were respiratory problems, which show that the pediatric anesthesiologists have to pay special attention to the respiratory system during anesthesia.