Background: Anesthesia in children carries unique risks and potential complications due to their distinct physiological and pharmacological responses. Understanding these complications is crucial for improving perioperative care in pediatric patients. Objective: To evaluate the incidence and types of anesthesia-related complications in children at a tertiary care hospital in Bangladesh. Methods: A prospective observational study was conducted at Community Based Medical College Bangladesh, from January 2023 to December 2024. A purposive sampling technique was used to enroll 183 pediatric patients (aged ≤12 years) undergoing various surgical procedures under anesthesia. Data on demographic characteristics, type of anesthesia, surgical procedure, and perioperative complications (respiratory, cardiovascular, neurological, or others) were collected and analyzed using MS Office tools. Results: The study found respiratory complications (23.5%) most prevalent, primarily desaturation (12.6%) and laryngospasm (6.6%). Cardiovascular events occurred in 8.7% of cases. Children <3 years had higher complication rates (31.2%) versus older children (16.4%). Emergency surgeries showed 28.9% complications compared to 13.8% in elective cases. Postoperative nausea & vomiting (14.2%) and emergence agitation (9.8%) were notable postoperative issues. No mortality was observed in this cohort. Conclusion: This study confirms respiratory complications as the primary anesthesia risk in Bangladeshi children, especially under age 3. Findings highlight the critical need for improved monitoring and tailored protocols to enhance pediatric perioperative safety. No mortality cases were observed.