Resistin is an adipokine mainly expressed in adipose tissue and was shown to be involved in hepatic glucose and lipid metabolism and appears to play a pivotal role in hepatic insulin resistance.  It has been documented that serum resistin may be implicated in the progression of chronic liver diseases towards cirrhosis. This study was conducted to evaluate serum resistin level in patients with chronic HCV infection and to evaluate its effect on the clinical picture and progression of the disease. To fulfill this aim, 36 patients with a chronic HCV infection were classified into two groups. Group 1: Included 18 cases of chronic HCV infection without evidence of cirrhosis (compensated) and Group 2: Consisting of 18 cases of chronic HCV infection with evidence of cirrhosis (decompensated). As well as 16 normal subjects were enrolled  as a control group (Group 3). Patients were further classified according to Child-Pugh classification that depends on the degree of deterioration of liver functions into three groups: Child A: 15 patients, Child B: 8 patients and Child C: 13 patients. All members of the study were subjected to thorough history taking, full clinical examination, abdominal ultrasound and laboratory investigations including CBC, ALT, AST, total and direct bilirubin, serum albumin, blood urea and serum creatinine. HCV virus antibody was detected by ELISA as well as estimation of serum resistin. The results of the study showed elevated serum resistin in both groups of chronic HCV as compared to the controls. The level of serum resistin was significantly higher in patients with HCV complicated with cirrhosis than compensated group. This finding may be of value in predicting the progress of HCV into cirrhosis. Moreover, according to the Child-Pugh classification serum resistin level was significantly higher in the diseased groups compared to control group. However, there was no significant difference between the various groups when compared to each other. Correlation study showed only positive correlation between ascites and serum resistin level.    From the previous finding it could be concluded that monitoring serumresistin could be of value in the follow up of patients for prediction early detection ofhepatic decomposition. However, its use for grading of liver dysfunction is not yet justified.