Background: Infections frequently cause the disease known as febrile thrombocytopenia. The goal of the current study is to understand the underlying causes of fever and thrombocytopenia as well as its varied manifestations and its hepatic dysfunctions in children admitted with fever and thrombocytopenia in our tertiary care hospital in south India. Methods: A Pre structured proforma was used to obtain information from the parents. Clinical features consisting of respiratory distress (tachypnoea, retractions), abdominal distension, tender hepatomegaly, and Jaundice are recorded at the time of admission. Laboratory investigations included CBP, Platelet count, Coagulation profile including INR, PCV, Serum proteins, serum Albumin, Total bilirubin, Aspartate aminotransferase (AST) Alanine aminotransferase (ALT). Results: The analysis of different liver enzymes and bilirubin levels was studied in the current study. The high AST levels were found in 10% of cases out of which 50% were in group II. The ANOVA analysis between the groups and AST values found p-values were significant. The ALT levels in the study were between the groups and >132 ALT values were found in n=9 cases out of which 77.78% were in group II the p-values were found to be significant. The serum alkaline phosphatase ALP was found in n=2 cases and they were in group II. Similarly, high levels of serum bilirubin were found in n=3 cases and all these cases belonged to group II and p-values were significant. Conclusion: In this study, we found 28% of the study sample had Dengue without warning signs 26% had dengue with warning signs 30% had Fever with Thrombocytopenia without warning signs and 16% had Fever with Thrombocytopenia with warning signs. It was found in this study that children with high AST values and high ALP values tend to have a poor prognosis and prolonged admission time as compared to those with lesser elevated values. In addition cases with high PT and aPTT, PCV >40 and platelet counts tend to have a severe form of the disease.