Background: Heart failure remains an essential reason of morbidity and mortality in children. The measurement of various biomarkers might be worthy incentive in the diagnosis. Objective: We studied the plasma level of MR-proADM as a promising novel diagnostic cardiac biomarker in pediatric patients with congestive heart failure and its relation to different clinical, laboratory and echocardiographic variables, aiming to promote their health through achieving good control of their cardiac symptoms and improving their quality of life. Patients and methods: The present study included 80 subjects in the pediatric age from (6 months – 16 years). They were classified into two comparative groups: case group included 40 pediatric patients, well diagnosed as having congestive heart failure and control group included 40 apparently healthy pediatric subjects. Results: There was an increase in MR-proADM level among cases group compared to control group and the difference was highly statistically significant. Conclusion: We concluded that there was a high diagnostic value of measuring plasma level of MR-proADM at admission, regarding the diagnosis in the setting of pediatric congestive heart failure.