Abstract Background: In December 2019, the severe acute respi-ratory syndrome coronavirus 2 (SARS-CoV-2) has infected millions of people across the globe and claimed hundreds of thousands of human lives. Indeed, elevated blood levels of IL-6 have been shown to correlate with COVID-19 disease severity and SARS-CoV-2 RNA blood levels in COVID-19 patients, and are also associated with a worse prognosis. Aim of Study: The aim of this work is to Study Efficacy and Safety of Tocilizumab in COVID-19 patients: The useful-ness of Tocilizumab (actemra) in patients with cytokine release storm and its efficacy to decrease mortality. Patients and Methods: This study was carried out in ICU Department, Egypt Air Hospitals, Retrospective clinical study from the period of 1/6/2020 to 1/6/2021, 100 patients with diagnosed Covid 19, (clinically, laboratory and radiologically). Results: Overall mortality in studied patients was 74 patients, 37 male and 37 female from the total 100 patients, Types of Organisms differentiation (cultured organisms) in studied patients, which 57% were candida, 21% were MRSA, 15% were Kliebsiella, 10%, Acinobacter and others were 4%. Incidence of improvement to hospital discharge studied pa-tients, From the total 100 patient 26 patients improved to home discharge differentiated moderate to severe. Conclusion: This study showed that tocilizumab did not reduce short-term mortality; low-certainty evidence from cohort studies suggests an association between tocilizumab and lower mortality. We observed a higher risk of infections and adverse events with tocilizumab use.