Background: Pediatric acute heart failure is now being increasingly recognized as an important source of healthcare resource utilization. B-type natriuretic peptide (BNP) continues to be the dominant biomarker in pediatric heart failure. This study aimed to prove the role of BNP in diagnosis and prognosis of congestive heart failure in children. Method: This case control study was performed in Zagazig University Hospitals and include 60 infants and children who divided into 2 groups, group 1 consists of 30 children diagnosed by congestive heart failure and group 2 consists of 30 age and sex-matched apparently healthy children. Serum BNP level measured for both groups with assessment to the cardiac function, CBC, CRP and serum creatin level. Result: BNP and is significantly higher among CHF patients compared to controls. BNP is found to be higher in patients with sever heart failure compared to moderate and mild HF patients with significance correlation. BNP is found to be higher among congestive heart disease patients with sensitivity 93.3% and specificity 76%. BNP is a significant independent diagnostic parameter for CHF. BNP is found to be non-significant prognostic factors for children with CHF. Conclusion: BNP continues to be the dominant biomarker in pediatric heart failure. BNP is a significant diagnostic marker in diagnosis of heart failure, while it found to be non-significant prognostic factor in CHF.