The prevalence of asymptomatic bacteriuria (ASB) and associated risk factors were investigated in 100 Egyptian children and adolescents with type 1 diabetes mellitus and 100 age and sex matched healthy controls. All were subjected to clinical evaluation and assessment of mean random blood glucose, mean glycosylated hemoglobin (HbA1c); microalbuminuria and midstream urinary samples were collected for complete urine analysis and two consecutive urine cultures and sensitivity tests. The prevalence of ASB was higher among diabetics than controls (30% versus 14%, p < 0.01) and was more among older age (p = 0.033) and female patients (p < 0.001); especially postpubertal. Microalbuminuria (36.7%) and microvascular complications (50%) were significant risk factors for ASB in patients while metabolic control and disease duration were not relevant to ASB (p > 0.05). Pyuria was a strong predictor of bacteriuria in patients (80%) and controls (100%). The most common isolates were E. coli in patients (30%) and Pseudomonas in controls (57.1%). Gram positive isolates were detected in 46.7% of diabetic patients but not in controls. ASB is more prevalent among type 1 diabetic patients in the pediatric age group. Screening for ASB is warranted in diabetic patients with risk factors especially if pyuria is detected in their urine analysis.