Objective: To determine the efficacy of steroid therapy in Sydenham’s chorea in children. Study Design: Comparative prospective study. Place and Duration of Study: Inpatient and Outpatient Department of Pediatric Neurology, Children Hospital and Institute of Child Health, Lahore Pakistan, from Dec 2019 to May 2020. Methodology: Sixty-eight children of Sydenham’s chorea were divided in Group A and B. Each Group was treated with Diazepam (0.3mg-1mg/kg/day) and an injection of Benzathine Penicillin. Group-B was given additional oral prednisolone (2mg/kg/day) for four weeks, with tapering in the next two weeks. Epidemiological data, clinical features and laboratory parameters were collected. The Universiade Federal de Minas Gerais Sydenham’s chorea Rating Scale (USCRS) was applied to both groups at the presentation after two weeks and four weeks. Results: Out of 68 patients, the mean Universidade Federal de Minas Gerais (UFMG) Sydenham's Chorea Rating Scale (USCRS) got progressively better in Group-B (mean score improvement was 25.73±5.56 at two weeks and 41.06±6.89 at four weeks) than in Group-A (mean score improvement was 9.12±3.75 at two weeks and 17.97±3.89 at four weeks) with p-value of <0.05. Conclusion: Steroid therapy significantly improved patients with Sydenham’s chorea compared to those who did not receive any steroid therapy.Keywords: Efficacy, Steroid therapy, Sydenham chorea.