Introduction: Sub optimal pain management in critically ill children is often linked to clinician misconceptions regarding opioid use, addiction risk, and pain assessment. Previous validated surveys have demonstrated persistent knowledge deficits among healthcare professionals. Local evaluation is necessary to inform targeted educational interventions. Objectives: To assess knowledge and attitudes of ICU doctors regarding evidence-basedpaediatric pain assessment and management, and to identify priority areas for educational improvement. Methods: A prospective clinical audit was conducted in the Medical Intensive Care Unit at Lady Ridgeway Hospital, Sri Lanka. All ICU doctors working during the audit period were invited to participate. An adapted version of the validated Pediatric Nurses’ Knowledge and Attitudes Survey Regarding Pain was administered before and after a structured educational intervention. The questionnaire assessed knowledge of pain mechanisms, assessment principles, opioid pharmacology , adjuvant therapies, and non-pharmacological strategies. Scores were expressed as percentages and analysed using paired-samples t testing. Results: Twenty-two of 31 eligible doctors participated (response rate 71%). The baseline mean score was 43.9% (SD 9.2), with marked deficits in opioid dosing, addiction risk, placebo use, and procedural pain management. Following the educational session, the mean score increased to 62.8% (SD 6.7), reflecting a mean improvement of 18.9 percentage points. The increase was statistically significant (t (20) =15.44, p