This study uses annual time series data on under five mortality rate for Sierra Leone from 1960 to 2020 to predict future trends of under-five mortality rate over the period 2021 to 2030. Residuals and forecast evaluation criteria indicate that the applied model is stable in forecasting U5MR. ANN model projections indicate that annual U5MR will decline but still remain high throughout the out of sample period. Therefore, we encourage the government of Sierra Leone to allocate more resources to the maternal and child health program and attend to various challenges that affect the quality of pediatric healthcare services across the country.