Background: Post-COVID-19 dyspnea is a complex condition characterized by persistent and distressing shortness of breath after recovery from acute COVID-19 infection. Objectives: This study aims to identify the possible causes and key factors contributing to post-COVID-19 dyspnea. Patients and methods: A cross sectional study was done at Qena University Hospital including 100 patients with post-COVID-19 dyspnea. The patient demographic data, ABG, CBC, 6MWT, spirometry, ECG, echocardiography and CT results were collected. Ct was done was done at acute COVID-19 phase, after 3 months and after 6 months. Results: The mean age of the study cohort was (60.06 years). Interstitial lung disease (51%) and ischemic heart disease (20%) were the main causes. Positive correlations were found between the dyspnea grade using mMRC and both ECG abnormalities, EF, CRP, TLC, lung abnormalities (bilateral ground glass opacities, CORAD IV), and interstitial pattern (diffuse intestinal thickening, honey combing), While there were negative correlations were seen with LVEDD, and serum Vit D. Conclusion: This study sheds light on the complexity of post-COVID-19 dyspnea, emphasizing the need for a multidisciplinary approach in the effective management of this condition.