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Pediatric inflammatory multisystemic syndrome (PIMS) is a new, rare and serious complication described in children and adolescents after SARSCoV-2 infection. This emerging disease is responsible for a myocardial damage of variable severity at often complicated by a state of cardiogenic shock. It's very particular by the vasoplegia and associated with a diastolic arterial hypotension. We report two cases of pediatric multisystemic inflammatory syndrome, which complicated by severe cardiac involvement, and associated with renal involvement, that making the management more delicate. Our objective is to determine the clinical, biological, and evolutionary particularities of the myocarditis of the pediatric multisystemic inflammatory syndrome, which is temporally associated with SARS-CoV-2 (PIMS-TS) as well as the difficulties of the management of this syndrome, that are associated to the cardiac and renal involvement. In conclusion, mortality in children with COVID-19-associated PIMS with severe cardiac involvement is rare thanks to the diagnosis and early management of these patients which is based essentially on the combination of immunoglobulin and corticosteroid therapy. [ABSTRACT FROM AUTHOR]