Acute rheumatic fever (ARF) is a major problem of public health in developing countries like Morocco. This study was done to find out the clinical manifestations and laboratory features of patients with ARF in Fez city. Methods: A retrospective study was conducted from 2009 to 2015 in the pediatric ward of the university hospital Hassan II of Fez. A total of 209 children (< 18 years) diagnosed ARF, based on modified Jones criteria, was included. Results: The mean age of ARF cases were 11 years. The sex ratio male/female was 0.9. The most represented age class was the class between 5 and 15 years. Unschooled represented 2.9% and the most found was the primary level school (58.9%). Urban residence was found in 84.2% of cases and the majority of patients with and without carditis were admitted in winter and autumn respectively. Cases of ARF with carditis was documented in 53.1% and without carditis in 46.9%. In the two groups, arthritis was the major criterion most represented and arthralgia was the minor criterion most represented. History of sore throat was found in ARF with carditis cases (51.3%) more than ARF without carditis cases (35.7%). Penicillin A was the most antibiotic prescribed in the two groups. Commonest valvular lesions among ARF with carditis cases was mitral regurgitation (62.1%). There were 3 deaths among cases in this group. Conclusion: ARF continues to occur in Morocco, despite the progress made in the socioeconomic development of the country, often associated with severe cardiac involvement.