Multisystem inflammatory syndrome in children (MIS-C) is a novel syndrome in children following the coronavirus disease 2019 (COVID-19) pandemic, which has similar symptoms to Kawasaki disease or toxic shock syndrome. The most prevalent symptoms in MIS-C patients are fever and gastrointestinal symptoms, with substantial cardiac complications. Cardiac involvement is frequently reported in MIS-C patients and includes arrhythmia, coronary artery aneurysm and dilation, conduction abnormalities, and ventricular dysfunction. Cardiogenic or vasodilatory shock may develop in patients with severe MIS-C, necessitating inotropic support, fluid resuscitation, mechanical ventilation, and extracorporeal membrane oxygenation. Empirical therapies have attempted to reverse the inflammatory response, and steroids or intravenous immunoglobulin have all been commonly used. Most children will survive with prompt diagnosis and appropriate treatment, but since the disease's outcomes are unclear, long-term follow-ups are necessary. This narrative review summarizes the available studies regarding cardiac involvement in MIS-C cases as well as clinical considerations for cardiac examination and follow-up.