Background: Micro-ribonucleic acids (MiRNAs) are small, non-coding RNA molecules which regulate gene expression. Several miRNAs including miR-23a were found to be frequently deregulated in hepatocellular carcinoma (HCC). Objective: This study aimed to evaluate serum miR-23a as a biomarker of hepatitis C related HCC. Methods: This study was conducted on 60 hepatitis C virus (HCV) infected patients (group I: without cirrhosis, group II with cirrhosis and group III with HCV associated HCC) and a control group of 20 healthy volunteers. All patients were submitted to history taking, clinical examination in addition to categorization and staging of HCC patients. Following extraction of RNA from serum samples, quantitative reverse transcription polymerase chain reaction (qRT-PCR) was performed. Calculation of serum miR-23a was done using the comparative cycle threshold (Ct) method (2–ΔΔCT). Results: Serum miR-23a levels (2-ΔΔCT) were significantly higher in cirrhotic and HCC patients compared to chronic hepatitis C patients (CHC). However, no significant difference was noted between cirrhotic and HCC patients. The sensitivity and specificity of miR-23a levels for discriminating HCC patients from cirrhotic patients were 55% and 65%, respectively. MiR-23a levels had sensitivity of 90% and specificity of 70% for discriminating metastatic from non-metastatic HCC patients. Conclusion: Higher miR-23a levels were detected among metastatic HCC patients than among those without metastasis. The sensitivity and specificity of miR-23a levels for discriminating HCC patients from cirrhotic patients were lower than those of alpha fetoprotein (AFP).