Introduction: Paediatric Computed Tomography (CT) scans are essential diagnostic tools, but they raise important concerns due to children's increased vulnerability to radiation risks compared to adults. In Zambia, the lack of locally established paediatric Diagnostic Reference Levels (DRLs) hampers efforts to standardise protocols and optimise radiation doses. This study introduces the first local DRLs and estimates the effective doses for paediatric head CT scans in Lusaka Province. Methods: A retrospective, cross-sectional study was conducted at three public hospitals in Lusaka, involving data from 337 paediatric patients aged 0-18 years who underwent head CT scans between 2019 and 2023. Effective Doses (ED) were calculated using age-specific conversion factors based on age-based DRLs, according to the ICRP protocol. Results: The established local DRLs showed an age-related increase, indicating the need for higher radiation parameters in older children. Median (IQR) DLP values ranged from 551.5 mGy·cm (IQR 456.10-653.80) for the <1-year age group to 793.4 mGy·cm (IQR 701.00-1210.00) for the 10-15-year age group. The overall median effective dose was 4.66 mSv (IQR 2.605-7.375 mSv). Significant differences in DLP values between centres were observed (p<0.0001). Patient age showed a moderate positive correlation with both CTDIvol (r=0.375, p<0.0001) and DLP (r=0.476, p<0.0001). Compared to international benchmarks, the DRLs displayed notable differences. Conclusion: This study has established local Diagnostic Reference Levels (DRLs) for paediatric head CT scans in Lusaka, Zambia. Variations in CT doses were observed across hospitals. It is advised that CT imaging protocols for paediatric patients be optimised. Collaboration between radiographers, radiologists, and medical physicists, along with comprehensive training for CT radiographers, is also recommended.