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Recurrent pericarditis, an inflammatory syndrome with a pathogenesis not fully elucidated, often presents diagnostic challenges. This study aims to assess the correlation of D-Dimer (D-D) and procalcitonin (PCT) levels with clinical, laboratory and imaging features in recurrent idiopathic pericarditis. We analyzed 412 patients with idiopathic recurrent pericarditis from 2019 to 2023 in our referral center. D-D and PCT values were obtained from emergency room in other Italian facilities. Among the cohort, PCT levels were assessed in 50 of 412 patients (12.1%), with only 4 showing marginal elevation. D-D levels were measured in 48 of 412 patients (11.6%), with 33 of them exhibiting elevated values. None of these patients had venous thromboembolism, and elevated D-D levels were significantly associated with pleural effusion, fever, higher CRP, increased white blood cell counts, higher neutrophil counts, reduced relative lymphocyte counts. Multivariate analysis revealed fever as the sole correlate of elevated D-D. PCT elevation was infrequent and unrelated to any variables. In idiopathic recurrent pericarditis unrelated to specific conditions, we observed a close association between elevated D-D levels and non-specific inflammation markers, including fever, increased CRP, and neutrophil leukocytosis. PCT levels were typically normal or mildly elevated., Competing Interests: Declarations. Conflict of interest: Prof Antonio Luca Brucato: Institution received funding from Kiniksa Pharmaceuticals, Ltd. as an investigative site; unrestricted research grants from SOBI and ACARPIA; travel and accommodation for the advisory committee from SOBI and Kiniksa. All other authors declare that they have no conflicts of interest. Ethical approval: Obtained. Human and animal rights statements and Informed consent: All participants provided informed consent prior to their participation., (© 2024. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).)