OBJECTIVES: To characterize the frequency, cost, and hospital-reported outcomes of cachexia and debility in children with complex chronic conditions (CCCC). METHODS: We analyzed data from the 2003-2012 data releases of the Kids’ Inpatient Database (Healthcare Cost & Utilization Project, Agency for Healthcare Research & Quality), utilizing International Classification of Diseases, 9^th Revision (ICD-9) diagnosis codes to identify cases. We compared patient and hospitalization characteristics for CCCC with and without cachexia (ICD-9 799.4) and debility (ICD-9 799.3). We examined factors which predict odds of inpatient mortality in CCCC using a logistic regression model and factors which impact length of stay and cost in CCCC using negative binomial regression models. All costs are reported in 2014 dollars, using the Consumer Price Index inflation adjustment. RESULTS: We estimated hospitalization incidence of cachexia in CCCC at 1,395 discharges during the sample period, which increased from 277 discharges in 2003 to 473 discharges in 2012, 421 discharges which included debility, which increased from 39 discharges in 2003 to 217 discharges in 2012. During the sample period, 5.73% and 2.44% of CCCC with cachexia and debility, respectively, died during their hospital stay. Cachexia was associated with a 59% increase in odds of inpatient mortality while debility was associated with a 41% decrease in odds of mortality. Both cachexia and debility increased hospital length of stay (15% and 31% longer stays, respectively). The median cost of hospitalization was $15,441.59 and $23,796.16 for children with cachexia and debility, respectively. CONCLUSIONS: The frequency of hospitalization for cachexia in CCCC is less than that for adults; however, the frequencies of cachexia diagnoses are increasing over time. Estimates of the incidence of hospitalization with debility in CCCC have not been previously reported in the literature, but our study demonstrates that the frequency of these discharges is also increasing.