Background: Improved survival following paediatric critical illness has increased attention to long-term functional impairment. Post-Intensive Care Syndrome in Paediatrics (PICS-p) may affect physical, cognitive, and functional recovery following PICU discharge. Aim: To determine the incidence of PICS-p among PICU survivors, identify associated clinical risk factors, and evaluate functional recovery during follow-up. Materials and Methods: This prospective observational study included 300 children aged 1 month to 18 years who survived PICU admission lasting more than four days at Indira Gandhi Institute of Child Health, Bengaluru. Functional status was assessed using the Functional Status Scale (FSS) before admission and at discharge. PICS-p was defined as an increase of ≥3 points in FSS. Affected children underwent follow-up at 1, 3, and 6 months. Results: PICS-p developed in 8 children (2.67%; 95% CI: 1.33–5.13%). CNS involvement was significantly associated with PICS-p (87.5% versus 30.1%; P=0.001). Median PICU stay was significantly longer among affected children (14.5 versus 5.0 days; P<0.001), as was hospital stay (26.5 versus 8.0 days; P<0.001). Mechanical ventilation (87.5% versus 14.4%; P<0.001), inotropic support (62.5% versus 20.2%; P=0.013), and nosocomial complications (62.5% versus 4.5%; P<0.001) were significantly associated with PICS-p. Among seven children with complete six-month follow-up, four (57.1%) achieved near-complete recovery, while three (42.9%) had persistent functional impairment. Conclusion: PICS-p affected a small proportion of PICU survivors but was associated with neurological involvement, prolonged intensive care, and greater organ support requirements. Structured functional assessment and follow-up may facilitate early identification of persistent impairment.