Familial Mediterranean fever (FMF) is a one of genetically basis auto inflammatory disease characterized by recurrent episodes of fever, serositis & musculoskeletal involvement. Protracted febrile myalgia syndrome (PFMS) is characterized by severe paralyzing myalgia, high fever, abdominal pain, diarrhea, arthritis/arthralgia, and transient vasculitic rashes. We report a 15year-old girl with PFM as non classical presenting symptoms of FMF, and discuss the course of management of this case.We reviewed the literature and mostly recorded all case reports of PFM affected adolesecent and adult patients over the past years to give special prominence to muscle affection in FMF particularly PFM Citation: Menyawi ME, Essam M, Shaker A, et al. Protracted febrile myalgia syndrome in patient with familial mediterranean fever.