Using the Overcoming COVID-19 network, this study identified and included 1659 children and adolescents (age <21) from 61 hospitals across 31 US states with acute illness hospitalization related to SARS-CoV-2, with the aim of investigating the extent of neurologic involvement in this population. Results showed documented neurologic involvement in 22% of patients in 52 sites across 29 states; these patients were more likely to have underlying neurologic conditions compared to others (p<0.001). Proportion of patients meeting multisystem inflammatory syndrome in children (MIS-C) criteria and previously healthy patients were similar in frequency in both groups. Four percent of patients who experienced neurological involvement died, while 5% was discharged with a new neurological deficit. This research will support future efforts to better understand the pathogenesis of neurologic diseases related to COVID-19 and MIS-C and its implications on children and adolescents.