Infective endocarclitis (IE) is an infection of the endocardium. It is not a common disease in pediatric but it because a high rate of morbidity and mortality. Modified Duke criteria are used for diagnosis of (IE) depending on major and minor criteria. Diagnosis of (IE) depends mainly on blood culture and echocardiography. Two major modalities are used in the treatment of (IE):- Antimicrobial therapy and surgical treatment. Recently, in 2007, the American heart association had made recommendation for prevention of (IE) that so different from recommendation promoted over 50 years ago.