CD4+CD25+ regulatory T lymphocytes are a subset of circulating CD4+ T cells with suppressive properties. CD4+CD25+ regulatory T cells suppress HCV-specific T cell responses and it has been suggested that they may play a role in viral persistence. Our aim was to assess the frequency of regulatory T cells in the different clinical presentations of hepatitis C virus infections in a chosen Egyptian population. Peripheral blood CD4+CD25+ regulatory T cells from patients with different progression of HCV, was conducted and analyzed using flow cytometry. For each stage of HCV progression, twenty patients (n=20) were subjected for analysis in comparison with normal healthy control subjects (n=20). Results showed a significantly higher frequency of CD4+CD25+ regulatory T cells in chronic HCV (3.0 ± 0.9%), HCV related liver cirrhosis (٣.٣±0.8%), HCV related-HCC (3.9 ±1.6%), when compared to normal healthy controls (2.3 ±0.8%). No statistical significant differences were found when comparing HCV related cirrhotic patients with chronic HCV infected patients (P=0.95). Meanwhile, statistical significant differences were detected when comparing HCV related HCC patients with chronic HCV patients (P=0.047). In conclusion, our results indicated the presence of significant higher than normal frequency of peripheral blood CD4+CD25+ regulatory T cell among Egyptian patients that may help to early detect the viral disease and open new field to find a way to disease recovery or protection. Conversely, within different clinical presentation of hepatitis C virus infection no significant differences were detected. Severity of liver affection was significantly correlated with viral load.