Background: Pediatric sepsis is a severe infectious condition that can rapidly progress to septic shock, increasing the risk of mortality. Early identification of risk factors through clinical characteristics and inflammatory biomarkers such as PCT is important for risk stratification and optimization of early management. Objectives: (1) To describe the clinical characteristics of children with sepsis at Can Tho Children’s Hospital (2) To evaluate the prognostic value of procalcitonin measured at the time of initial sepsis diagnosis in predicting septic shock. Materials and methods: A prospective cohort study was conducted on 100 pediatric patients with sepsis aged 1 month to 16 years who were treated at Can Tho Children’s Hospital from June 2024 to February 2026. Results: Among 100 children with sepsis, 40% progressed to septic shock and 11% died. The median age was 13 months (IQR: 5.0–45.0), male pediatric patients accounted for 57% and the malnutrition rate was 20%. Respiratory infection was the most common source of infection (62%). The initial PCT concentration was higher in the group that progressed to septic shock than in the non-progressing group. In logistic regression analysis, PCT was not statistically significant in the univariable model but became an independent factor associated with the risk of septic shock after adjustment for age and nutritional status (adjusted OR=1.20; 95% CI: 1.01–1.42; p=0.043). After adjustment for age and nutritional status, the PCT-based prediction model demonstrated a moderate discriminative ability for septic shock, with an AUC of 0.641 (95% CI: 0.532–0.751; p=0.017). Hosmer–Lemeshow test indicated a good model fit (p=0.590). Conclusions: Procalcitonin measured at the time of initial sepsis diagnosis is independently associated with the risk of septic shock in children; however, its discriminative ability remains limited. Further studies with larger sample sizes and serial measurements of procalcitonin are needed to better clarify the prognostic role of this biomarker.