Background: Acute iron toxicity is a common poisoning that may result in acute liver injury, which may proceed to fulminant hepatic failure. The aim of the study: to assess the serum miRNA-(122 and 192) expression levels in acute iron poisoned cases and investigate their role in early detection of the hepatic injury as compared with liver parameters (ALT, INR). Patient and Methods: This prospective study was conducted on 12 acute iron poisoned patients and 12 healthy controls admitted to Zagazig University Hospitals and Zagazig General Hospital between April 2024 and March 2025. ALT, INR, serum miRNA-(122 and 192) expression and iron level were measured for patients on admission, at 24 and 72 hours. While, serum levels of ALT, INR and miRNA-(122 and 192) expression were measured once for controls. Results: The studied patients were 3 males (25%) and 9 females (75%). Mean age was 13.58±3.17 years. On admission, the miRNA-(122 and 192) levels were raised significantly in patients compared to controls (p<0.01). In patient group, over time (at 24 and 72 hours), the ALT and INR levels were raised significantly (p<0.01), while iron and miRNA-(122 and 192) were declined significantly (p<0.01). MiRNAs expression was displayed a positive correlation (p<0.05) with the iron dose ingested, serum iron, ALT, INR and the duration of hospitalization. Conclusions: This study suggests the probable role of miRNA-(122 and 192) as biomarkers for early detection of acute liver injury in acute iron poisoned cases, and suggests their superior diagnostic performance compared to ALT and INR.