Introduction: Corticosteroids are potent anti-inflammatory agents used as a mainstay of therapy in most rheumatologic disorders, inflammatory , neurologic, and other conditions. High-dose corticosteroids administered as intermittent intravenous boluses for 3–5 days constitute pulse therapy . Corticosteroids have long been used, and their expected side effects are well known. However, there is limited literature on heart rate variability and its use. The objective of this study was to evaluate cardiovascular adverse events associated with pulse methylprednisolone therapy . Case Report: This was a retrospective review of case records of hospitalized children 1 to 14 years of age who received pulse methylprednisolone therapy from 1st January 2025 to 31st December 2025. Results showed all 12 children who received intravenous methylprednisolone had slowing of heart rate with 7 (58.3%) children developed bradycardia with sinus rhythm. Interestingly , the mean reduction in HR of all cases was found to 56/min. as compared to baseline. The onset ranged from 4 to 68 hours after starting therapy , most commonly within the first 48 hours. The lowest heart rates recorded ranged between 48 beats per minute. The duration of bradycardia varied from 24 to 104 hours.. All cases were asymptomatic and resolved spontaneously without stopping steroid therapy or requiring medical intervention. Only one hild developed Stage II hypertension. Conclusion: Pulse methylprednisolone therapy in children may be associated with transientand asymptomatic bradycardia, especially at higher doses. Although generally benign and self-limiting, careful heart rate monitoring during and shortly after therapy is recommended to ensure patient safety .