Cardiomyopathy can result in significant morbidity and mortality, leading to long-term cardiac disability or consideration for transplantation. This study reviewed our experience with pediatric burn patients who developed cardiomyopathy during their acute hospitalization. We identified five patients admitted from 1991 to 2003 who were diagnosed with cardiomyopathy during their initial hospitalization and retrospectively collected data regarding hospital course, cardiac dysfunction, radiographic and echocardiographic studies, pharmacologic treatment, and long-term cardiac function. All children were Caucasian males with extensive full-thickness burns requiring prolonged ventilatory support. Initial signs and symptoms of cardiomyopathy, including radiographic and echocardiographic evidence, were noted greater than 30 days after injury. Patients received a combination of digoxin, diuretics, angiotensin-enzyme converting inhibitor, and beta-blocker therapy. During follow-up over the course of 2 to 11 years, all patients returned to normal cardiac function. Cardiomyopathy after extensive burn injury appears reversible. With prompt diagnosis and treatment, cardiac function normalizes within 9 to 21 months after the initiation of treatment.