Objectives: to evaluate levels of NT Pro-BNP, Troponin I and Troponin T in ARDS patients with structurally normal hearts and to detect the association between these markers with 30 day mortality and other respiratory parameters and scoring systems.Design: Prospective study.Setting: Critical Care Medicine Department- Cairo University Hospital.Patients and Methods: 20 patients diagnosed to have ARDS according to the criteria of the American-European Consensus Conference in 1994 admitted from 1 June 2008 until 1 April 2009. All patients were subjected to APACHE IV on admission, SAPS II on admission, GOCA score on admission, at day 2 and at day 7, transthoracic echocardiography on admission, mechanical ventilation with Lung protective ventilation strategy as well as NT Pro-BNP, Troponin I and Troponin T on admission, at day 2 and at day 7.Results: NT-Pro-BNP, cTn I and cTnT mean values were significantly lower in survivors group than the nonsurvivors group(p< 0.001). NT-Pro-BNP was inversely correlated with PH and PaO2/FiO2 ratio. NT Pro-BNP was positively correlated with PEEP. NT Pro-BNP was not significantly correlated with PaCO2, HCO3, PaO2, SaO2, FiO2, PAO2, P(A-a)O2, a/A ratio and lung mechanics including C.dyn , RaW, Ceff, PIP, Pplat and Pmean. cTn I and cTn T showed no significant correlation with all above parameters. NT Pro-BNP was positively correlated with APACHE IV, SAPS II and GOCA score. cTn I and cTn T was positively correlated with APACHE IV only. The optimal threshold of NT Pro-BNP was 1200 pg/mL. At this the sensitivity for prediction of 30-day mortality was 100% and the specificity was 86%. cTn I cutoff was 1.5 ng/mL. At this the sensitivity for prediction of 30-day mortality was 100% and the specificity was 57%. cTn T cutoff was 0.5 ng/mL. At this the sensitivity for prediction of 30-day mortality was 100% and the specificity was 43%.Conclusion: NT Pro-BNP, Troponin I and Troponin T cardiac markers are elevated in ARDS patients with structurally normal hearts. The higher the N-terminal Pro-BNP, Troponin I and Troponin T cardiac markers level during the first week of ARDS, the worse the chance for surviving. NT-proBNP is more accurate in detecting mortality in ARDS than Troponin T and Troponin I.