Background: Biomarkers perform a crucial role in initial diagnosis, differential diagnosis, risk assessment, management monitoring, and estimation of prognosis of sepsis. Objective: To evaluate the role of the Presepsin biomarker in the assessment of patients with sepsis in comparison with the Sequential Organ Failure Assessment (SOFA) score at the emergency department in Suez Canal university hospital. Patients and Methods: This was a cohort study conducted on 42 patients who met the inclusion criteria Q-SOFA score for assessment of patients who were complaining of sepsis at the emergency department in Suez Canal University hospitals during the period from November 2020 to April 2021. Data was collected using a preorganized questionnaire involving medical history, clinical examination, and investigations. Sepsis SOFA score was calculated for each patient in the study to confirm their state. Presepsin blood level was assessed for each patient. Moreover, the patient was followed up 48 hours later to assess the mortality rates in comparison to their presepsin level. Results: Patients with septic shock had significantly higher Presepsin levels (3.66 ± 0.78) compared to patients with sepsis (3.46 ± 0.52) (p=0.018).  A value of 3.585 was found to be the best cut-off point to predict the incidence of septic patients from patients with sepsis, with sensitivity = 64% and specificity = 64.71%. died patients had significantly higher presepsin levels (3.78 ± 0.7) compared to survived patients (3.29 ± 0.56) (p=0.017). Conclusions: Presepsin is a promising biomarker with great precision in expecting the prognosis of sepsis under the sepsis-3 criteria, besides its discriminative power in differentiating between sepsis and septic shock.