Abstract Background: Multisystem inflammatory syndrome in chil-dren (MIS-C) is a dysregulated immune response to viral infec-tion by COVID-19 accompanied by systemic manifestations. Macrophage migration inhibitory factor (MIF) exerts inhibitory effects on macrophage migration and is raised in adult cardiac critical illness Aim of Study: To identify the role of MIF as a marker of cardiac affection in MIS-C patients. Patients and Methods: This case-controlled study was con-ducted on 24 MIS-C children and 24 apparently healthy con-trols. Clinical and laboratory data were compared between both groups. Echocardiography was done for all participants. Results: Myocardial injury markers as troponins, CK-MB and liver injury markers were significantly (p>0.05) elevated among MIS-C patients than controls. MIF expression was also significantly higher (p>0.05) among MIS-C patients. Impaired LV function and valve regurgitation were the main echocardio-graphic findings among MIS-C patients. MIF correlated sig-nificantly with age, lymphocytic count, ferritin, LDH, D-dimer, CK-MB, EF%, LVESD, LVEDD, Z-score RCA and Z-score LCA. Conclusion: Myocardial injury is common in MIS-C pa-tients. Impaired LV function is the most prominent echocardio-graphic finding. MIF could be considered as a biomarker for MIS-C and correlated significantly with myocardial affection among those patients.