Abstract Background: Ultrasound plays a crucial role in the non-invasive evaluation of chronic HCV patients, particularly in limited resources setting where it can provide an easy-to-use and cheap imaging modality. Ultrasound can evaluate the liver size, texture, liver edge, hepatic parenchyma, presence of liver nodules, and hepatic vascularity, as well as the affection of spleen and venous supply. In most hepatic centers, ultrasound is a part of the routine evaluation of chronic HCV to evaluate the stage of disease and the severity of fibrosis. The present study assessed the frequency of abnormal ultrasonographic findings in Egyptian patients with chronic HCV infection. Aim of Study: This study assessed the fruency of abnormal ultrasonographic findings in Egyptian patients with chronic hepatitis C virus (HCV) infection. Patients and Methods: A cross-sectional study was con-ducted on HCV patients presented to the Cairo University hospitals through the period from July 2014 to July 2015. All examinations were performed by the same operator. Results: Three hundred patients were included in the present study. The mean age of the included patients was 48.1 ±13 years old and nearly 60% of the patients were males. Overall, the prevalence of abnormal ultrasound findings during abdominal examination was 60.7% (n=180). Besides, 20% of the patients had enlarged spleen, with an average size of 13.9±3cm. Conclusion: In conclusion, our findings highlight the high prevalence of abnormal ultrasound findings amongst Egyptian patients with chronic HCV. We found that more than 60% of the chronic HCV patients had variable degree of abnormalities during abdominal ultrasound findings. Thus, ultrasound ex-amination should be implemented as routine investigation during evaluation of chronic HCV patients, which can provide an easy-to-use, reliable, and cheap modality in limited settings.