Background: Acute drug exposure in children is a common and preventable cause of pediatric morbidity, particularly in low- and middle-income countries. Children are especially vulnerable due to exploratory behavior, unsafe medication storage, and delayed access to healthcare. Data focusing specifically on drug-related exposures and outcomes in Bangladeshi children remain limited. Aim of the study: To evaluate the clinical characteristics, exposure patterns, management strategies, and short-term outcomes of acute drug exposure in children admitted to a tertiary care hospital. Methods: This retrospective observational study was conducted in the Department of Pediatrics of a tertiary care teaching hospital. Medical records of 80 children aged <18 years admitted with acute drug exposure were reviewed. Data on demographics, type and route of exposure, drug categories, clinical presentation, severity, interventions, and outcomes were collected and analyzed using SPSS version 26. Descriptive statistics were used to summarize findings. Result: Most patients were aged 1–5 years (52.5%), with a male predominance (56.25%). Accidental exposure accounted for 87.5% of cases, predominantly via oral ingestion (95%) and occurring at home (93.75%). Analgesics/antipyretics (22.5%) and antibiotics (20.0%) were the most common drugs involved. The majority had mild toxicity (70%) and presented within two hours. Complete recovery was observed in 87.5% of cases, while mortality was 5%. Conclusion: Acute drug exposure in children is largely accidental, home-based, and associated with favorable outcomes when managed promptly. Strengthening preventive strategies, caregiver education, and early medical intervention is essential to reduce adverse outcomes.