Rheumatic fever is an inflammatory disease, which occurs as a delayed sequel to group A hemolytic streptococcal upper respiratory traet infection. This study included 36 cases with acute rheumatic fever admitted to the Pediatric Hospital – Cairo University through the period from 1 January 1999 to the end of June 1999. 72% of them has history of pervious affection of acute fever, rheumatic heart disease and rheumatic arthritis formed 94% and 70% respectively. They were undergone laboratory investigation, echocardiography, analytical study and compared to previous reports both by Egyptians and Foreigners.