Background <p>Dysnatremia is a common electrolyte abnormality in children, but its prevalence and impact in pediatric earthquake victims are not well established. This study aimed to define the frequency of dysnatremia in pediatric earthquake victims and evaluate its relationship with complications, mortality, and morbidity.</p> Methods <p>We retrospectively analyzed data from 312 pediatric patients admitted to our hospital after the 2023 Türkiye–Syria earthquakes. Patients were categorized based on admission sodium levels: hyponatremic (&lt; 135 mmol/L), hypernatremic (&gt; 145 mmol/L), and normal (135–145 mmol/L). Demographic, clinical, and laboratory data were analyzed.</p> Results <p>Of the 312 patients, 36.2% were hyponatremic, 17.3% were hypernatremic, and 46.5% had normal sodium levels. The frequency of fasciotomy, crush syndrome (CS), acute kidney injury (AKI), and dialysis treatment was significantly higher in the hyponatremic patient group compared to those with normal sodium levels (<i>p</i> &lt; 0.001). Hypernatremic patients also had a longer time under the rubble at 121 ± 64 h, compared to 35 ± 41 h in patients with normal sodium (<i>p</i> &lt; 0.001). Mortality was 5.4%, with no significant difference between dysnatremic and normonatremic patients.</p> Conclusions <p>Dysnatremia is common in pediatric earthquake victims. Dysnatremia is&#xa0;associated with increased morbidity, including CS and AKI. Monitoring&#xa0;and management of sodium abnormalities are crucial in the care of pediatric earthquake survivors.</p> Graphical abstract <p></p>