Acute respiratory failure is the most common emergency disease in Pediatric Emergency Resuscitation. In addition, it is also one of the common causes of circulatory arrest and death in children worldwide. We conducted a cross-sectional study to describe the clinical and paraclinical characteristics of acute respiratory distress syndrome in 245 children aged 2 months to 5 years over a period of one year from July 2023 to July 2024 at the Pediatric Center, Thai Nguyen National Hospital. The results showed that: the age group was mainly 2 - < 12 months 60.8%; male/female: 1.7/1; underweight children 19.2%; obesity 1.2%; grade II respiratory failure accounted for the highest rate 57.1%. Common clinical features of acute respiratory failure are rapid breathing (92.7%); chest retraction (71%); cyanosis (60.8%); SpO2 below 90% (59.6%); respiratory muscle contractions (60,4%); abnormal breathing sounds (54.1%); 46.1% tachycardia; 3.7% refill > 2 seconds; 20% stimulation; 6.9% lethargy. Paraclinical results showed 25.7% leukocytosis; 22.4% hemoglobin decrease; 42.4% platelet increase; 35% CRP > 6 (mg/l). Symptoms of acute respiratory failure in children are diverse. Early detection and timely treatment are needed to limit mortality as well as the rate of sequelae.