Background and aims.  Hepatocellular carcinoma (HCC) is the most common primary liver cancer and is one of the leading causes of cancer related deaths. The aim of this study is to investigate characters and risk factors in the development of hepatocellular carcinoma (HCC) in Mansoura University Hospitals. Methods. The study included 220 patients with HCC plus 246 control patients from general population of rural areas of Dakahlia. All the study population was randomly selected. Diagnosis of HCC was based on ultrasonography and confirmed by triphasic computerized tomography and /or triphasic MRI. Results. Compared to patients without HCC, patients with HCC were significantly male (76.8% vs. 62.0%), smoker (32.7% vs. 14.2%), diabetes mellitus (24.1%vs. 8.9%), and had a positive hepatitis C virus (HCV) infection (55.9% vs. 13.0%), hepatitis B virus (HBV) infection (5.5% vs.0.4%)  and schistosoma infestation (67.7% vs. 44.3%). HCC cases were characterized by, cirrhotic (81.8 %), child B score (47.7), found in right lobe (47.3%), had multifocal lesions (49.1%) and presented with portal vein thrombosis (26.4%). The OR and 95% Confidence interval (CI) of HCC were (OR 36.9, 95% CI 18-75.8) for anti- HCV positive patients and (OR 84.807, 95% CI 8.6- 835.59) for HBsAg positive patients on multivariate analysis. The OR for diabetes (OR 0.31, 95% CI 0.18-0.53), smoking (OR 0.343, 95% CI0.217-0.54) and schistosomiasis (OR 0.376, 95% CI 0.257-0.559) in Univariate analysis. Conclusions. Infection with HBV and HCV and schistosomiasis infestation are the major risk factors for the development of HCC in Egyptian patients.