Background: Hepatitis C virus (HCV) –is the leading cause of chronic liver disease worldwide. Many studies have shown an association between hepatitis C and type 2 diabetes mellitus (DM2) and increase of insulin resistance could play a crucial role. Glucose homeostasis may become extremely difficult because most oral hypoglycemic drugs are contraindicated if hepatic or renal function were reduced. Thus, insulin remains the elective treatment. Insulin-resistance (IR), HCV infection, carbohydrate metabolism disorders and difficulties in dietary management, make to be achieved specially in those with renal function impairment or failure. Aim: The present study aims to investigate the correlation between the hepatitis C affection (in chronic renal failure patients on regular hemodialysis ) and Hyperglycemia as a case control study in Egyptian patients.. Methods: The study group consisted of 70 patients who were on regular hemodialysis therapy (group (1): a 35 HCV positive and group (2): a 35 HCV negative). Each group was subdivided according to HOMA' score into HOMA(+) with HOMA score >2.5 and HOMA(-)with HOMA score < 2.5. All patients and normal control group (n =35) were subjected to the estimation of fasting blood sugar(glucose) (FBS), alanine transaminase (ALT), aspartate transaminase (AST), and fasting serum insulin, HOMA score Results: serum insulin levels, ALT, AST, and duration of hemodialysis of HCV +ve patients were statistically significantly higher than those of HCV -ve. and activities of ALT, AST, and HOMA score in HCV-ve patients were significantly higher than those in normal controls. Among HOMA score (+) patients there was a statistically significant increase of serum insulin and HOMA score in HCV +ve group than HCV -ve group. Among HCV +ve patients there were statistically significant correlation between ALT and both insulin level and HOMA score. Conclusion: Hepatitis C virus infection enhances insulin resistance in chronic hemodialysis Egyptian patient.