Rheumatic fever (RF) is an inflammatory disease that affects many systems in the body (multisystem disease). It is a delayed outcome of untreated group A streptococcal pharyngitis. The major organs that can be involved in RF are the heart (the connective tissues of the heart), joints, skin, and vessels. RF occurs most frequently in the age between five to 20 years. In developing countries, rheumatic fever is endemic and remains one the major causes of acquired cardiovascular disease because of lacking the suitable antibiotics for group A step. pharyngitis. Heart disease associated with rheumatic fever accounts for 25-50% of all cardiac admissions worldwide. Also, RF is a major cause of mortality among individuals under 50 years of age. Arthritis is present in about 75% of patients. RF has higher prevalence in developing countries. The annual incidence rate of RF can reach up to 30 million new cases. The incidence rate in developing countries is estimated to be 100-200 times greater than that observed in industrialized countries. Treatment depends on the symptoms associated with RF. Aspirin is the choice to treat fever and joint pain/swelling. Antibiotics should be given to the children without carditis at least up to adulthood, whereas patients with carditis must complete taking the antibiotics forever. Also, prophylactic antibiotics must be given to prevent further infections.