Background: Under five mortality is a major health concern worldwide. Nigeria ranks third in under five mortality worldwide. Attaining the SDG 3.2, which aims at reducing neonatal mortality to 12% and under five mortality to 25% by 2030, can be made possible by regular evaluation of the under-five mortality status and its related factors. Aim: To evaluate the morbidity and mortality pattern and related factors in children aged 1-60 months at University Teaching Hospital in south-east Nigeria. Methods: A retrospective study of all admissions in children aged 1-60 months at the Paediatrics Department of Abia State University Teaching Hospital, from January 1st 2017 to 31st December 2017 was conducted. Results were presented prose and frequency tables. Test of significance for discrete variables was done using the Chi-square test. P-value <0.05 was regarded as significant. Result: There were 440 admissions. Males were 270 and females were 170 giving a male: female ratio of 1.6: 1. Many, 400 (90.9%) were in the 1-36 months age group, while 40 (9.1%) were in the 37- 60 months age group with no significant difference in their gender p= 0.153. Malaria 155 (35.2%), sepsis 95 (21.6%) and acute watery diarrhea 84 (19.1%) were the leading morbidities with significantly more morbidities recorded within the 1-36 month age group p=0.028. The greatest monthly morbidity 81 (18.4%) occurred in February. The mortality rate was 13.6% with sepsis, malaria and acute watery diarrhea being the leading causes of mortality; 82.3% were discharged home, 1.8% absconded, while 1.1% was discharged against medical advice. Conclusion: The mortality rate in this study was high. Morbidities and mortalities occurred significantly more in the 1-36 month age group and were due to preventable causes. Early diagnosis and aggressive treatment of diseases in the under-fives should be re-emphasized.