Abstract Background: Colonoscopy is the most accurate diagnostic tool in IBD. It is useful in detection of the severity and extent of UC. the incidence of IBD especially UC increased significantly among Egyptian patients as evidenced in previous studies in the past ten years. Aim of Study: To study the prevalence of UC among patients referred to the internal medicine endoscopy unit to perform colonoscopy and evaluate the most common presenting symptoms of UC. Patients and Methods: Cross sectional study encompassed 190 patients who underwent colonoscopy during the period from October 2018 to October 2019, the main presenting complaint was recorded and the result of colonoscopy. Results: Prevalence of UC was about 11.05% on the other side, internal hemorrhoids was the commonest diagnosis in group I (Non-UC patients) 26.6% followed by nonspecific colitis in 23.6%. Bleeding per rectum was the main symptom and indication for colonoscopy (50.5%) but was not signifi-cantly different among studied groups. Conclusion: Prevalence of UC raised in Egypt in the last years. In this study, it was the 3rd diagnosis after internal hemorrhoids and non-specific colitis constituting about 11.05%.