Background: Post-infarct left ventricular systolic dysfunction (LVSD) has been identified as a powerful marker of poor prognosis. Its occurrence is associated with an increased risk of cardiac death, re-infarction, and rehospitalization. Furthermore, half of patients diagnosed with early post-infarct LVSD subsequently develop chronic heart failure. There is close relationship between increased C-reactive protein (CRP) concentrations in patients with myocardial infarction (MI) and increased mortality. Objectives: The aim of this work was to evaluate the significance of high-sensitivity C-reactive protein (hs-CRP) as a marker of early LVSD in patients with ST-segment elevation myocardial infarction (STEMI). Patients and methods: This study included 78 patients, presented with STEMI and received reperfusion therapy either by fibrinolytic drugs (streptokinase 1.5 million units by intravenous infusion) or primary percutaneous coronary intervention (PCI). Patients were classified according to post-MI left ventricular systolic function (LVF) into two groups: Group 1, patients without LVSD with left ventricular ejection fraction (LVEF) >50% (44 patients) and Group 2, patients with LVSD with LVEF <50% (34 patients). hs-CRP plasma concentrations were checked 48h after admission. Echocardiography was done on admission, and after 1 and 3 months of follow-up. Results: There was no statistical difference in both groups with regard to liver functions, kidney functions, and lipid profile, whereas hs-CRP, ESR, EF, wall motion score index, and modified Gensini risk score index were significantly higher in Group II in early and after 1-3 months of follow-up. The prevalence of LVSD was significantly increased across increasing tertiles of hs-CRP concentration, both at 48 h after admission (cut-off values of < 6.9mg/L and >13.9mg/L for the lower and upper tertiles, respectively). 2 Conclusion: hs-CRP plasma concentration 48 h after admission is a marker of early LVSD and remodeling in patients presented with STEMI.