Background: Cytokine storm causes ARDS, multiple organ failure and post covid-19 pulmonary sequale so anti-inflammatory drugs as tocilizumab and methylprednisolone are widely used to treat covid-19 patients. Methods: prospective observational study on 60 covid-19  patients >18 years old. Diagnosis of covid-19 infection was based on World Health Organization (WHO) criteria and confirmed by nasal and pharyngeal swab for real time reverse transcriptase polymerase chain reaction analysis. 30 hypoxemic covid-19 who received tocilizumab and 30 hypoxemic covid-19 patients who received high dose of methylprednisolone.then Comparison of both groups regarding duration of admission, length of Oxygen need, resolution of CT findings and inflammatory marker levels. Results: There was no significant difference ( p-value >0.05) between the two treatment protocols as regards CT findings at time of admission and after a month from discharge. On admission, Higher mean of CRP, D-dimer and a lower mean of procalcitonine were noted   among the group treated with Tocilizumab protocol while significantly lower mean of ferritin (p-value <0.05) .After one month follow up there was no difference in CRP level between the two groups. Also there was no statistical significant difference between the two groups regarding hospital stay and length of oxygen therapy between the two groups. Conclusion: lower ferritin and higher D-Dimer were noted in tocilizumab treated group while no difference in radiological finding or length  of hospital stay between the two groups