Background: Pediatric sepsis is a major cause of morbidity and mortality in babies and children all over the world. Pediatric sepsis has become more common in the last 20 years, and an increasing number of these patients have co-morbid illnesses. Objectives: To assess the utilization of presepsin as a biomarker for early septicemia identification and its prognosis in order to direct antibiotic treatment. Patient and methods: In this case-control study, 20 patients with suspected hospital-acquired septicemia and 20 non-septic patients served as the control group in the pediatric critical care unit and the neonatal intensive care unit at Aswan University Hospital. Results: The mean presepsin levels in the sepsis group were significantly greater than in the control group, and they decreased steadily over time in accordance with treatment, reflecting the strong power of presepsin in sepsis predection. Conclusion: Presepsin is a promising biomarker for diagnosis of nosocomial sepsis predict its prognosis.