Background: Hepcidin plays a vital role in controlling iron homeostasis. Functional iron deficiency, as well as anemia, are common in heart failure, and it is hypothesized that hepcidin plays a significant role in both conditions. This study aimed to assess the relationship between hepcidin and anemia with the correlation of cardiac functions among congestive heart failure (CHF) pediatric cases. Methods: Our case-control study was performed in the Pediatrics department at Zagazig University Hospital. It included 42 participants divided into Group I: 21 cases of congestive heart failure, and Group II: 21 healthy controls. Serum hepcidin level was assessed a mong all participants. Results: A statistically significant decrease was found in hepcidin levels among studied CHF cases (p<0.001). High statistically significant positive correlations were found between hepcidin level and hemoglobin, red blood cell (RBCs) count,serum iron and ejection fraction (EF) of the studied cases (p<0.001, 0.008, <0.001, <0.001 respectively). There was a higher statistically significant decrease in hepcidin level assessed among severe CHF cases (ROSS grade 4) than cases of grade II and III (p<0.001). The sensitivity of hepcidin level in the prediction of CHF was 95.2% at a level less than 30.8 with the ability to exclude 90.5% of healthy cases and 92.9% test accuracy. The sensitivity of hepcidin level in the prediction of severe CHF was 85.7% at a level less than 27.6 with the ability to exclude 78.6% of mild cases and 83.3% test accuracy. Conclusions: In children with congestive heart failure, serum hepcidin level is a promising biomarker for anemia, and it can predict the severity of heart failure