Objective: This study aimed to evaluate the prognostic value of Hearttypefatty acid binding protein for adverse outcomes in septic patient incomparison to Troponin.Methods: We conducted a prospective study on 50 patients admitted tothe critical care department, Cairo university hospitals, all diagnosed withsepsis, severe sepsis, and septic shock. Patients demographic data ,APACHE II , SOFA , SAPS II scores , blood levels of H-FABP andTroponin I were compared between survivors and non survivors . Theassociation between H-FABP and survival was analysed with multivariatelogistic regression and Cox proportional hazards regression analyses.Results: Of the 50 patients 35(70%) died, the mortality increased withpositive H-FABP (88% vs 32%). In multivariate regression analysispositive H-FABP increased the odds of mortality 7.5 times. Coxregression analysis showed that H-FABP had a significant impact onsurvival duration (P value < 0.001, HR 4.27, CI 95% 1.69-10.79) whileTroponin I had no impact (P value NS, HR 1.39, CI 95% 0.63-3.08).Conclusions: H-FABP is a better prognostic marker in patients withsevere sepsis than Troponin I. H-FABP is an independent risk factor inmortality in patients with severe sepsis and septic shock.