Introduction: Dengue fever is an arboviral infection spread by the mosquitoes Aedes agepty and Aedes albopictus. The majority of these instances have been documented in Southeast Asian locations, which are popular tourist destinations. Aim: To assess the severity and outcome of acute hepatitis in patients presenting with dengue fever. Methodology: The study included all patients under the age of 14 who were hospitalized with a diagnosis of Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF), or Dengue Shock Syndrome (DSS). The Chi-Square test and, when appropriate, the Fischer exact test were employed to compare categorical variables. For the primary outcome, a survival analysis (Cox regression and log-rank) was performed. To compare continuous variables, the student test was utilized. Significance was defined as a p-value of less than or equal to 0.05. Cross-sectional study. This study was conducted at Suleman Roshan Medical College Hospital Tando Adam Pakistan from January 2020 to January 2021. Results: Total 500 cases were included in the study, with 87 % (435) having DF and 13% (65) having DHFs or DSS. The median ALT was 87.91 IU/L; IQR 42.78-181 IU/L, the median AST was 179 IU/L; IQR 85-369.3 IU/L, and the median T.Bil was 0.8 mg/dl; IQR 0.6-1.3 mg/dl, according to liver function tests. A total 71 % (355) of the patients had mild to moderate hepatitis, whereas 15 % (75) had severe hepatitis. In patients with mild/moderate hepatitis, the average length of stay (LOS) was 3.63 days, compared to 4.3 days in those with severe hepatitis (P-value 0.002). Overall mortality in the mild/moderate hepatitis group was 36.84% (n = 7) compared to 63.15% (n = 12) in the severe hepatitis group (p-value 0.001). The severe hepatitis group (H.R (4.91; 95 % CI 1.74-13.87 and P-value 0.003), as well as the DHF/DSS group, had substantially increased mortality (H.R (5.43; CI 1.86-15.84 and P-value 0.002). In the mild/moderate and severe hepatitis groups, there was a substantial difference in sequelae such as bleeding (P-value 0.001), Acute Renal Failure (ARF) (P value 0.002), Acalculus cholecystitis (P-value 0.04), and encephalopathy (P-value 0.02). Conclusion: In Dengue fever, severe hepatitis (ALT__ampersandsigngt;300IU) is linked to a longer length of hospital stay, mortality, hemorrhage, and renal failure. Apart from typical hepatotropic viruses, dengue fever should be evaluated when liver tests are abnormal.