Background <p>Febrile seizures (FS) are events in infancy or childhood, usually between 6 months and 5 years of age, associated with fever but without signs of intracranial infection or a defined seizure cause. Studies suggest that both the inflammatory response and genetic predisposition play crucial roles in FS development. Pro-inflammatory cytokines such as IL-1β and their natural antagonist IL-1Ra are key mediators in this complex interaction.</p> Objective <p>This study aimed to evaluate IL-1β, IL-1Ra levels, and the IL-1Ra/IL-1β ratio in Moroccan children with FS and to explore their associations with demographic and clinical parameters.</p> Patients and methods <p>This descriptive, cross-sectional study was conducted over six months (September 2022–February 2023) in children aged 6 months to 6 years admitted for FS to the pediatric emergency departments of the University Hospital (CHU) in Casablanca. Serum IL-1β and IL-1Ra levels were measured using enzyme-linked immunosorbent assay (ELISA). Comparative analyses assessed cytokine levels according to age, sex, family history, consanguinity, and temperature at admission.</p> Results <p>IL-1β levels were generally low, whereas IL-1Ra levels were markedly elevated, resulting in a high IL-1Ra/IL-1β ratio. IL-1Ra was significantly lower in children from consanguineous families. No significant differences were observed according to other parameter age, sexe, temperature or history of FS or epilepsy.</p> Conclusion <p>These findings suggest an imbalance between pro- and anti-inflammatory mediators in FS, reflected by elevated IL-1Ra relative to IL-1β, potentially as a compensatory mechanism limiting IL-1β’s pro-convulsant effects. Genetic and demographic factors may influence this equilibrium, highlighting the need for further studies with larger cohorts to explore underlying mechanisms.</p>