Background: Egypt has the highest prevalence rate of hepatitis C virus in the world, making it the most challenging public health problem facing the country. Cardiovascular disease continues to be the principal cause of death worldwide. Several studies have been conducted to confirm, or disprove, an independent association between HCV infection and atherosclerotic disorders, including coronary artery disease. Objective: the aim of this study was to assess the correlation between hepatitis C virus infection severity and extent of coronary artery disease. Patients and Methods: this prospective study was carried out in the Cardiovascular DiseasesUnit in Ain Shams University Hospitals. This study involved sixty one patients with positive test for HCV antibodies. Results: PCR level was highly correlated to the absolute Syntax score  (SS) and to the Syntax score group, yet it was not found to be significantly correlated to the presence of significant coronary lesion nor to the number of vessels affected. On the other hand SS was highly correlated to the presence of significant coronary lesion and to the number of vessels affected.