Abstract: Objective To assess the diagnostic value of Doppler color echocardiography for Kawasaki disease (KD) with cardiac involvement. Methods Doppler color echocardiography was performed in 58 KD cases for measurement of the diameter of the coronary artery and the dimensions of the ventricles. The ejection fraction (EF) of the heart was also calculated and the presence of pericardial effusion and valvular regurgitation examined. Results Cardiac involvement was identified in 31 (53.45%) of the total 58 patients, and 28 patients were found to have coronary artery lesions. Uncomplicated left and right main stem coronary artery lesions were detected in 17 and 3 patients, respectively, lesions involving both two coronary arteries in 8, coronary aneurysms in 2, left ventricle enlargement in 9, right ventricle enlargement in 6, and enlargement of the whole heart in 4 patients. Eighteen patients had mitral regurgitation, 16 had tricuspid regurgitation, 13 had pericardial effusion, and 2 developed temporary cardiac dysfunction. Conclusions Doppler color echocardiography is capable of depicting dynamically the pathological changes and progression of the coronary artery lesions with prognostic indications, to serve as the most valuable non-invasive modality for diagnosis of KD with cardiac involvement.