Objectives <p>Rotavirus is the primary cause of diarrhea and severe dehydration worldwide; approximately half a million children aged &lt; 5 y succumb to these diseases, with 90% of cases occurring in underdeveloped countries. This study was carried out to describe the epidemiological, sociodemographic, clinical, and genotypical distribution of children aged &lt; 5 y with acute gastroenteritis (AGE). The authors also aimed to estimate the prevalence of rotavirus diarrhea and its association with clinical and sociodemographic characteristics.</p> Methods <p>This prospective hospital-based study was conducted across three hospitals in Hazaribagh, Jharkhand, following the introduction of the rotavirus vaccine in Jharkhand's Universal Immunization Program on April 7, 2018. Children aged &lt; 5 y admitted to either of the three sites between December 2019 and December 2023, with diarrhea as the primary complaint, were included. For all eligible children, case report forms containing information on their clinical and sociodemographic characteristics were completed, and vaccination information and stool samples were collected.</p> Results <p>A total of 739 eligible children with a primary diagnosis of AGE were screened from all sites in Hazaribagh, and 466 (63%) children were enrolled in the study. Stool samples collected from 461 children were screened for rotavirus using enzyme-linked immunosorbent assay; 165 (35.8%) children were identified as rotavirus-positive. The most common genotype isolated was G2P[4] (40.6%), followed by G1P[8] (36.4%).</p> Conclusions <p>This study emphasizes that rotavirus-associated diarrhea remains a significant cause of pediatric hospitalization. Community-based research is needed to explore the relationship between rotavirus infection and the sociodemographic characteristics of hospitalized children.</p>