Abstract Background: The current SARSCoV-2 epidemic, centred in Hubei Province, China, has spread to many other nations. The WHO Emergency Committee declared a global health emergency on January 30, 2020 due to rising case reporting rates in China and elsewhere. Remdesivir works. Its active counterpart penetrates cells and inhibits viral RdRp, halting vi-ral replication. Aim of Study: The study aimed to compare between tocili-zumab and remdesivir versus remdesivir in hospitalized pa-tients with severe COVID-19 pneumonia. Subjects and Methods: The study was Interventional, rand-omized, and double-blinded controlled trial, conducted at ICU Department, El Demerdash Hospitals from Jan. 2023 to June 2023 (Over 6 months) on 100 hospitalized cases with COV-ID-19 infection. Results: In all visits there were significant variation amongst the 2 groups regarding Albumin and ALT U/L, WBCs and RBCs, Urea, eGFR, Negative CRP, D-Dimer, Procalci-tonin, IL6, and ESR, heart rate and rhythm, NW CPAP Mask, Non-rebreather Mask, CPAP NW, and Simple mask. Regarding Stability of vital signs, and fit for discharge from ICU there was no significant variation among the two groups concerning Blood pressure and Temperature. Conclusion: In summary, there was significantly decreased oxygen requirement and higher room air consumption, high-er improvement of chest condition and lower death, higher discharge from ICU and higher hospital stay till discharge in patients receiving tocilizumab plus remdesivir than patients re-ceiving remdesivir alone.