Objective To analyze the risk factors for death in septic shock patients in pediatric intensive care unit (PICU), so as to provide basis for formulating early prevention and treatment measures to reduce death in septic shock. Methods Clinical data of children with septic shock who were admitted to PICU of a hospital from May 2015 to May 2018 were analyzed retrospectively, according to shock outcome, they were divided into survival group and death group, risk factors for death were analyzed by univariate and multivariate logistic regression analysis. Results A total of 62 children with septic shock were collected, of which 31 survived (survival group), 23 died (death group), 8 gave up treatment, mortality of children with septic shock was 42.6%. Multivariate logistic regression analysis showed that the independent risk factors for death in septic shock were decrease of albumin, the number of organ dysfunction more than 3, increase of blood glucose, increase of C-reactive protein, effective resuscitation time more than 6 hours, maintenance of blood pressure with drug, positive bacterial culture, and low lactate clearance rate at 6 hours. Compared with the death group, lactate level in survival group was significantly lower (1.4[1.2-2.1]mmol/L vs 5.6[3.5-8.7] mmol/L) and the lactate clearance rate was significantly higher (0.4[0.23-0.52]% vs -0.16[-0.39-0.13]%) at 6 hours after resuscitation, with significant difference (both P<0.05). Procalcitonin level in survival group was lower than death group (1.1[0.5-1.6] ng/mL vs 23.5[12.9-55.1] ng/mL), procalcitonin clearance rate was higher than death group (0.47[0.27-0.69]% vs -0.9[-5.5-0.1]%), differences were both statistically significant (both P<0.05). Conclusion Children with septic shock have a high mortality, early monitoring of organ function, dynamic determination of lactic acid level and effective fluid resuscitation are conducive to improving prognosis.