Background: Chronic hepatitis C virus (HCV) infection has been linked to numerous co-existing conditions including metabolic abnormalities and cardiovascular disease. Stroke is a major public health crisis world-wide. About 87% of strokes are ischemic. Between 25- 40% of ischemic stroke may be cryptogenic. HCV infection is associated with a wide spectrum of extra-hepatic manifestations, affecting different organ systems. Neurological complications occur in a large number of patients and range from peripheral neuropathy to cognitive impairment and/or cerebral infarctions (CI).  Objective: Studying the role of HCV infection in patients having CI. Patients and Methods: After departmental ethics committee approval and patient consents were obtained, 60patients included in this work: 20 patients having CI and chronic hepatitis C (CHC), 20 patients having CI without CHC, and 20 patients having CHC without CI. All patients were subjected to history taking and clinical examination, complete blood count (CBC), evaluation of HCV antibodies, polymerase chain reaction (PCR) for HCV ribonucleic acid (RNA), hepatitis B surface antigen (HBs-Ag), liver function tests, renal function tests, lipid profile, antinuclear antibody (ANA), anticardiolipin antibodies immunoglobulin G (ACL-IgG), antineutrophil cytoplasmic antibodies (ANCA), cryoglobulin, fasting plasma glucose (FPG) and post-prandial plasma glucose (PPPG). In addition, ultrasound (U/S) abdomen, magnetic resonance imaging (MRI) brain, doppler study of the carotid arteries and echocardiography. Results: Group A (CI and CHC) patients were significantly younger and females were predominant in these patients than those of either group B (CI without CHC) or C (CHC without CI) .Group B patients were significantly overweighed compared to group A or C. Total cholesterol (TC), triglyceride (TG), FPG and low density lipoprotein (LDL) significantly decreased in group A and C compared with group B .Patients of group A showed significantly higher positive of HCV viremia, cryoglobulins, ANA, c-ANCA and ACL-IgG, compared with group C, while those of group B were negative for same parameters. Carotid atherosclerosis and ischemic heart disease (IHD) were significantly higher in patients of group A, compared with group (B and C), respectively. Conclusion: Chronic HCV infection is a risk factor in development of CI by multiple mechanisms including atherosclerosis, thromboembolism and vasculitis. Also, it increases stroke risk and might be considered as an important and independent risk factor.