Background Myocarditis, an inflammatory condition of the myocardium, presents a significant health concern in pediatric populations. Detecting and monitoring myocardial injury in children with myocarditis is crucial for timely intervention and improved patient outcomes. This study investigates the correlation between troponin I levels and echocardiographic findings in pediatric patients diagnosed with myocarditis. The primary objective is to determine the strength and significance of the relation between troponin I levels and echocardiographic parameters in pediatric myocarditis patients. Secondary objectives include evaluating the diagnostic utility of troponin I as a biomarker for myocardial injury in this population and assessing the predictive value of echocardiographic findings in relation to clinical outcomes. Method The research design encompasses a retrospective analysis of medical records of pediatric patients (age range: 1 month to 192 months) admitted to Northwest General Hospital and Research Center, Peshawar, with suspected or confirmed myocarditis over a specified period (Jan 2015 - July 2023). Troponin I levels and echocardiographic data, including left ventricular dimensions Dr. Mohammad Arif/Afr.J.Bio.Sc.6(13) (2024) Page 8133 and ejection fraction, were collected and statistically analyzed to explore potential associations. Data was retrieved from the hospital database and was analyzed using SPSS 25. Result The study groups comprised 48 patients with confirmed/suspected myocarditis. The mean age was 27 months (1–146 months), and 68.75% (n = 33) were male while 31.3% (n = 15) were female. When patients were classified according to the clinical severity of the disease on the basis of Echo, 17 (35.42%) patients were having normal Echocardiogram, 16 (33.33%) patients were having severe LV dysfunction, 10 (20.83%) patients were having moderate LV dysfunction while 05 (10.42%) patients were having mild LV dysfunction. On the basis of troponin I levels there were 14 (29.2%) patients having troponin I levels in between 10-100 ng/ml, 12 (25%) having troponin I levels in between 101-200 ng/ml, 07 (14.58%) having troponin I levels in between 201-500 ng/ml,03 (6.25%) having troponin I levels in between 501-1000 ng/ml, 07 (14.58%) having troponin I levels in between 1001-2000 ng/ml, while 04 (8.33%) having troponin I levels greater than 2000 ng/ml. ANOVA showed no statistically significant variation among troponin I levels and echocardiogram, with a P value of 0.055. Conclusion Both troponin I levels and echocardiogram should be done in patients with acute myocarditis/suspected myocarditis, as troponin I will aid in the timely diagnosis of the disease, while echo will aid in assessing the severity of the disease, as both are correlated to each other.