Biagiarelli FS, et al. - Children with low back pain (LBP) presenting to pediatric Emergency Department (ED) were examined for their characteristics, etiology and health care use alongside developing an algorithm to design a diagnostic approach. In this 7-year cohort study of children admitted to ED with a primary complaint of LBP, 140 females (52.6%) and 126 males (47.4%), with a median age of 10.5 years, were included. Hospitalization of 80 children (30.3%) was reported, with an average length of stay of 8.53 ± 9.84 days. Among 148 patients with non-traumatic/non-visceral LBP, severe prognosis conditions (SPCs) accounted for 28 patients (18.9%). In this group, earlier onset and longer duration of symptoms were observed in correlation with SPCs than non-SPCs. In this study, they recognized significative high-risk factors (red flags) correlated with serious outcomes (SPC group) compared to the non-SPC group, thereby ensuring specific treatment. Based on previous literature and the findings of this study, an algorithm was developed that needs to be validated in future prospective research.