Background: Coronavirus disease 2019 (COVID-19) has spread worldwide and poses a serious public health-threat. High IL-6 levels were associated with the severity of COVID-19 and del to the use of anti-IL-6 Tocilizumab during the pandemic. Therefore, this case-control study was conducted to evaluate the role of Tocilizumab on the mortality rate among severe and critically ill COVID-19 patients. Method: A case-control study relied on the use of an electronic data collection sheet; the data were collected from February to May 2022. The study was performed on adult patients with critical COVID-19 at three major hospitals in the Gaza Strip, Palestine where patients were treated in the intensive care units (ICUs). Patients from the hospitals were included and divided into two groups by simple random sampling technique. Results: Of the 202 patients with critical COVID-19 admitted to ICUs of three hospitals, 102 (50.5%) were treated with Tocilizumab. A total of 58 (56.9%) patients in the Tocilizumab group were cured, and 44 (43.1%) died. In the control group, only 26 (26.0%) were cured and 72.0% died. There was no statistically significant effect of Tocilizumab on total hospital stay and ventilation periods. Patients treated with Tocilizumab had a longer stay in the ICU (14.02 ±8.796 days compared to 10.52 ± 9.596 days in the control group, P = 0.027), but shorter incubation periods were observed in the same group (3.25 ±1.137 days in Tocilizumab group compared to 7.38 ±3.376 days in the control group P = 0.036). Conclusion: This study found that administration of Tocilizumab can improve clinical outcomes, reduce risk of mortality, and frequency of intubation in patients severely infected with COVID-19. However, there was no significant difference between the two groups in terms of hospitalization times and mechanical ventilation needs. Based on the current report, healthcare specialists should consider Tocilizumab with the updated treatment guidelines for critically ill COVID-19 patients.