Nematode infection including Ascariais is a worldwide infection [1,2]. Nematode infection in particular ancylostomiasis and ascariasis have long been prevalent in Egypt and trials to trace this infection goes back to Lord Kitehenere in 1913 [3]. Although the decline in the incidence of this form of infection in Egypt, due to application of good hygienic techniques, mass and effective treatment ……etc, we reported a 55 years old male patient with chronic hepatitis C virus infection, nonresponder to pegylated interferon therapy complained from persistent epigastric pain and was non-responder to multiple courses of proton pump inhibitors. We decided to examine this patient by upper gastrointestinal endoscopy, where this long white worm was seen in the duodenum ; extraction by biopsy forceps was done.