Background: Patients diagnosed with refractory epilepsy (RE) are those who do not achieve control of their seizures even after the application of several antiepileptic drugs (AEDs), therefore the implementation of an adjuvant treatment, such as the ketogenic diet (KD), becomes necessary. The aim of the present investigation is to describe the management with ketogenic therapy in pediatric patients with refractory epilepsy treated at the Roosevelt Institute between 2019 and 2020. Methods: Observational, descriptive, retrospective study, included a sample of 25 pediatric patients diagnosed with RD attended by the nutrition service in a hospital institution in Colombia, who initiated treatment with CD. Those who met the inclusion criteria were identified, a form was designed in the Redcap platform to collect data, including sociodemographic characteristics, anthropometric data, nutritional management information and clinical data related to their underlying disease. Subsequently, a descriptive analysis was performed. Results: The study included 9 patients, all under management with classic ketogenic therapy, 8 cases were fed orally, and one was a gastrostomy user. The main associated side effects were emesis and diarrhea. Partial reduction of seizures was observed in most patients (88.9%) and one case presented total remission of seizures (11.1%). Likewise, during therapy, 5 patients were able to reduce the number of indicated AEDs. Conclusions: CD is an adequate treatment alternative in pediatric patients with RD, contributing to the reduction of epileptic seizures in patients.