Sepsis, still cause morbidity and mortality in children admitted to the pediatric intensive care unit (PICU). Several diagnostic and biological markers have y been studied to monitor unfavorable evolution of sepsis in critically ill patients but didn’t established. Objective: This study aimed to evaluate the Left ventricle ejection fraction, serum Ferritin and C - reactive protein and find out their value as early prognostic markers for outcomes in pediatric sepsis in PICU. Patients and Methods: 40 patients admitted to a PICU diagnosed with sepsis. Echocardiography study: to figure out the ejection fraction (EF) of the left ventricle, serum levels of C-reactive protein and ferritin on D1 and D3 after admission. Patients followed to detect their outcomes and mortality. Results: We found with cardiac dysfunction by echocardiogram and elevated ferritin levels on D1 had longer hospital stay in, prolonged duration of mechanical ventilation use, higher maximum inotropic score, and fewer ventilator-free hours. Both low Left ventricle ejection fraction and high serum Ferritin are associated with unfavorable outcomes. Conclusion: Cardiac dysfunction by echocardiogram (EF < 55%) and serum ferritin values (≥300 ng/mL) on D1 of admission in pediatric patients with sepsis admitted to the PICU, were significantly associated with unfavorable outcomes.