Protein-energy malnutrition (PEM) is a major public health problem affecting a high proportion of infants and older children worldwide. As malnutrition progresses every organ system of the body gets affected and multiple metabolic derangements are expected. To study thechanges in serum protein and electrolytes in children with acute protein energy malnutrition. Present study was a hospital based cross sectional study. 50 children with PEM and equal number of controls of age group 1-5 years were included in the study. Details were collected in predesigned proforma. Total serum protein, albumin and globulin levels, serum sodium and potassium were estimated. The parameters were compared among cases and controls using appropriate statistical tool. The mean value of total serum protein in cases was 5.91± 0.92 g/dl and in controls was 7.02 ± 0.50 g/dl. The mean value of serum albumin and serum globulin in cases was 2.99 ± 0.74 g/dl and 2.91 ± 0.44 g/dl and in controls was 4.06 ± 0.40 g/dl and 2.96 ± 0.47 g/dl. The mean value of serum sodium and serum potassium in cases was 133.6 ± 4.38 mmol/l and 3.2 ± 0.63mmol/l in controls was 137.09 ± 2.88 mmol/l and 4.18 ± 0.38mmol/l. The decrease in the serum sodium, potassium, total serum protein and albumin were significant statistically (p<0.05) but the decrease in serum globulin was not statistically significant. Children with protein energy malnutrition has altered biochemical parameters. This study concluded that there is significant decrease in the serum sodium, potassium, total protein, and albumin levels (p values<0.05) in malnourished children when compared with normal, while the decrease in serum globulin was insignificant.