Background: The incidence of patent ductus arteriosus (PDA) is inversely related to gestational age. Cardiac troponin T (cTnT) is a specific marker for myocardial ischemic injury. The aim of this work was to investigate if a hemodynamically significant patent ductus arteriosus leads to elevated   high- sensitivity troponin T (hsTnT) levels in serum. Methods: This prospective observational research included 60 preterm infants <34 weeks’ gestation, weighing <1500 g with PDA. Patients were classified into two groups according to the ECHO findings: Group A: preterm infants who had hs.PDA (PDA >1.5 mm and LA: Ao >1.2 and group B: preterm infants without hs.PDA. All cases were subjected to clinical examination, echocardiogram and hsTnT assay. Results: Serum hsTnT levels was significantly elevated in patients with hs PDA compared to patients without hs PDA. High sensitive T-troponin can significantly detect hsPDA with AUC of 0.986, P value <0.001. At cut off >100 pg/ml, it’s a significant detector with sensitivity of 93.33%, specificity of 90%, PPV of 90.3, NPV of 93.1 and diagnostic accuracy of 91.5%. PDA had a significant positive correlation with hsTnT (r=0.803, P<0.001). Conclusions: HsTnT can significantly detect hemodynamically  significant PDA in preterm infants with high sensitivity and specificity.