Background: There are 170 million people in the globe living with hepatitis C virus (HCV) infection, which causes inflammation and hepatic fibrosis in various degrees. A portion of these patients will develop cirrhosis and other end-stage liver disease problems over the course of twenty to forty years. Low levels of serum ceramide 24 (Cer24) are linked to severe liver fibrosis and poor response to antiviral therapy in those with chronic HCV infection. Objective: This study was designed to assess level of ceramide 24 in chronic HCV and normal individuals. Subjects and Methods: The study was carried out as a case control study at Tropical Medicine Department, Clinical Pathology Department in Zagazig University Hospitals and at Viral Hepatitis Treatment Unit in Al-Ahrar Teaching Hospital. The study included 60 individuals who were divided into 2 groups. Group 1 included 30 case and group 2 was 30 healthy subjects as control. All patients were clinically evaluated, had routine laboratory investigations and measurements of circulating levels of ceramide 24. Abdominal ultrasonography was done. Results: Serum ceramide 24 level in HCV patients (cases) is 15.16 ± 6.93 while its level in normal individuals (control) is 65.01 ± 65.84.  Conclusion: It was found that serum ceramide 24 level was significantly reduced in case group.