Background Syncope is one of the most prevalent paroxysmal disorders in children and adolescents. It is a transient, self-limited loss of conscious and postural tone that is followed by a full recovery spontaneously and without any neurological consequences. Aim The objective of this internal audit is to assess how much the staff at Assiut University Children Hospital (AUCH) are sticking to the agreed upon unit’s protocol regarding how to deal with children or adolescent with syncopal attacks. Patients and methods This clinical audit was conducted on 150 pediatric patients with syncope who were admitted to Assiut University Children Hospital, Egypt during the period from the start of January 2021 up to the end of June 2022. Data was systematically collected regarding medical history, general, and systematic examination including chest, cardiac, abdominal, and neurological examination. Duration of syncopal attack (minutes), prodrome history, related symptoms (as chest pain or palpitations), and triggers (as hyperventilation, pain, stress, or effort) were all collected. Results The mean age of the studied participants was 11.96 ± 2.47 years (range 1.5–15 years), with slight female sex predominance. The neurocardiogenic causes (vasovagal, VVS) were the main cause for syncopal attacks among our studied cases, followed by neurologic causes in 17.3%. Collectively, we could say that our institution is successfully following the recommended protocol of our institution for the management of syncopal attacks in children and adolescents. Conclusion The recommended protocol of our institution for the management of syncopal attacks in children and adolescents was successfully followed by the staff members at Assiut University Children Hospital.