To determine the risk factors for hospitalization in 0 to 24-month-old children with acute diarrhea, a retrospective case-control study was done at the Diarrheal Diseases Training and Treatment Center, where all the cases are managed according to World Health Organization (WHO) criteria. For each hospitalized patient, the next two consecutive admissions were enrolled as the control group. Clinical history and detailed physical examination results on admission were obtained from the standard file for all patients. The two groups were found to be similar for age, sex, height, blood in stool, and duration of diarrhea on admission. However, more children in the hospitalized group had high purging rate, frequent vomiting, malnutrition, dehydration and fever, and were not breast-fed on admission compared to the control group in univariate analysis. In multiple logistic regression analysis, only high purging rate, presence of dehydration and absence of breast-feeding on admission were the statistically significant factors. Mothers should be advised to seek early medical attention if the child has high purging rate (more than 8/day) and to continue breast-feeding up to 24 months of age. Multi-center studies with a large number of cases should be done to clarify the possible risk factors for hospitalization in cases with acute diarrhea.