The aim of this study was to determine the causative agent of acute respiratory infections (ARIs) in hospitalized children, as well as investigate the characteristics of ARIs with single and multiple pathogens detection from July 2015 to June 2016. The objective of the present study was to examine the role of viruses, bacteria and mix infection of both in hospitalized children with ARI and their correlation with two divergent geographical settings of Odisha. Hospitalized children with ARI aged < 5 were recruited from July 2015 to June 2016. Nasopharyngeal/Oropharyngeal swabs were collected for detection of common respiratory viruses by reverse transcriptase polymerase chain reaction (RT-PCR).Bacteria were isolated by routine culture methods. The analysis revealed 150 (56%) were detected with >1bacteria, 40(15%) with > 1virus, 22(8.2%) with > 2 bacteria and 20(7-4%) with both bacteria and virus. Most frequently detected pathogens were Klebsiella pneumonae, Setrptococcus pneumonae, Parainfluenza A and Influenza A virus. Incidences of pathogens were detected more among children < 1 year, Gender discrimination in the form of dietary neglect of the female children has also been noted mostly in case of tribal patients. Social demographic factors associated with high detection of respiratory pathogens could be responsible for high incidence of respiratory pathogens mostly in tribal population. Till date perhaps no study has been under taken to document the epidemiology of ARI in the state that will facilitate to implement control and prevention measures.