<p>Clinical ethical issues in paediatric practice are relatively common due to the nature of the doctor-parent-patient relationship, as these patients run the spectrum from newborns, infants, children and adolescents. The Clinical Ethics Consultation Service (CECS) was established at Hospital Al-Sultan Abdullah (HASA) in 2020. It has played a crucial role in addressing the ethical issues and dilemmas faced by healthcare professionals in their clinical practice. This study aimed to identify common ethical issues encountered in paediatric practice at HASA to provide recommendations on improving clinical ethics support. A qualitative approach employing key informant interviews (KIIs) was utilised. Five HASA paediatricians were interviewed. The results were divided into three sections. Section one focused on common ethical issues encountered by paediatricians. The issues were related to clinical decision-making, refusal of treatment by parents, end-of-life issues and resource allocation. Section two focused on the paediatrician’s understanding and experience of clinical ethics which yielded mixed responses. Section three looked at input regarding the development of paediatric clinical ethics support. Recommendations include promoting the CECS and its services through awareness and educational programmes at HASA. It also recommends enhancing case consultations through participation during grand rounds, providing ethics education and training, as well as guidelines and policy development in paediatric practice at HASA. This study provided meaningful insights into common ethical issues faced by paediatricians at HASA and recommendations on how clinical ethics can support their practice. It also adds to the limited literature on clinical ethics in Malaysia.</p>