Background: Early diagnosis and prompt treatment of ascitic fluid infection (AFI) is vital to shorten hospital stays and reduce mortality in patients with cirrhosis. The gold standard for diagnosing AFI is ascitic fluid analysis, but it is invasive. Procalcitonin (PCT) has been studied as a noninvasive diagnostic tool in adult cirrhotic patients. Pediatric literature is limited. Hence, we prospectively evaluated the role of serum PCT levels in predicting AFI in hospitalized cirrhotic children between November 2017 and December 2019. Methods: We prospectively evaluated all consecutive children <18 years of age with decompensated chronic liver disease (CLD) who had ascites at presentation and who did not receive antibiotics in the last 7 days. The clinical features and laboratory parameters were evaluated. Ascitic fluid analysis and serum PCT estimation (cutoff value <0.5 ng/mL) were done in all patients. Results: A total of 30 children {20 boys, median age 9.1 years [interquartile range (IQR) 3.6–10.5]} with decompensated CLD were evaluated. Wilson disease was the most common etiology followed by cryptogenic cirrhosis. Seven (23.3%) children had AFI (1 spontaneous bacterial peritonitis, 6 culture-negative neutrocytic ascites). The mean [± standard deviation (SD)] serum PCT was 2.57 ± 1.2 ng/mL in the infected group and 1.4 ± 1.0 ng/mL in noninfected group (p < 0.05). Receiver-operator characteristic (ROC) curve showed that serum PCT of ≥2.02 ng/mL had an area under ROC of 0.807, sensitivity of 71.4%, specificity of 74%, positive predictive value (PPV) of 45.5%, and negative predictive value (NPV) 89.5% for the diagnosis of AFI. Conclusion: PCT can be a useful, noninvasive tool for the diagnosis of AFI in cirrhotic children.