Early interventions in children with autism spectrum disorder (ASD) reduce progressive symptom development. Delay in diagnosis and initiation of ASD-specific interventions is observed across settings. This study aimed to assess the trends in time to diagnosis and treatment initiation in a tertiary care pediatric setting. Families of children with ASD (n= 50) were assessed, and details regarding age at first symptom recognition, medical consultation, receiving the diagnosis, and initiation of treatment were collected, in addition to detailed clinical assessment. About 70% of families met a pediatrician for initial concerns, and 20% received a diagnosis of ASD from the first-contact pediatrician. The mean age at initial symptom recognition was 22.22±9.47 months, whereas the first consultation was 27.22±10.83 months. The mean age at initiation of ASD-specific interventions was 36.58±10.2 months, amounting to an overall delay of 14.38 months from initial symptom recognition to treatment initiation. The time delay in our study is found to be lesser compared with similar studies across settings. Pediatricians have a significant role to play in early diagnosis and care of children with ASD in close liaison with child psychiatry teams. Improving awareness, routine screening, and prompt referral of children “at-risk” for ASD are imperative. Initiating ASD-specific interventions in pediatric or primary care settings is an effective alternative to curtail the delay in treatment initiation.