The aim of this work was to study morbidity and mortality before implementing the setting up of the pediatric service of Bamako. Involved in the study were all the children hospitalized during 12 months that is a total of 2000 cases among which 57.3% boys and 42.8% girls. Our study indicated that only 25% of children (509/2000) were referred. The most encountered pathologies were : malaria 898 (44.9%), ARI 528 (26.4%), diarrhea 224 (11.2%), malnutrition 269 (13.4%) and anemia 239 (11.9%). Mortality rate in hospital was 7.1 % and the main causes of deaths were : malaria (23.9% of death cases), diarrhea (20.4%) and malnutrition (31.7%). Thus we have recorded 8.3% of deaths for a period of resort beyond 3 days, compare to 3.3 % for a resort of less than 24 hours. (x² = 8.10, p= 0.017 ). The pediatric service operated as a center for first contact. In the framework of the establishment of this project, organizational efforts should allow to receive only referred cases.