Background: Tuberculosis remains a major cause of morbidity in children, particularly among household contacts of pulmonary TB cases. The Tuberculin Skin Test (TST) is an established, cost-effective tool for screening and diagnosing latent infection in this vulnerable group. Objectives: To estimate the prevalence of TST positivity among pediatric contacts of pulmonary TB patients and to compare the clinical, socio-demographic, and hematological profiles of infected and non-infected children, identifying predictors of latent tuberculosis infection. Methods: This cross-sectional study included 384 pediatric contacts aged >5 to <15 years. After excluding confirmed active TB, 295 children were assessed for latent infection using TST. Clinical history, socio-demographic factors, hematological and inflammatory parameters were systematically recorded and statistically analyzed. Results: Of 295 eligible children, 174 (58.9%) were TST positive. Positivity increased with age (p=0.001) but showed no association with sex or socioeconomic status. TST-positive children had significantly lower hemoglobin, reduced TLC, elevated platelets, and higher ESR/CRP, reflecting immune alterations linked to infection. Conclusion: Over half of exposed pediatric contacts harbored latent TB infection. TST proved reliable in identifying infection, with higher prevalence in older children and strong association with hematological and inflammatory markers, emphasizing the need for early screening and preventive strategies.