Background: Thrombocytopenia is a common hematological abnormality observed in patients infected with hepatitis C virus (HCV). Thrombocytopenia is a well-known relative contraindication for the initiation of antiviral therapy in HCV-infected patients and may also result in the postponement of many invasive procedures that chronic liver disease (CLD) patients may need to undergo. This study aiming to determine the platelet response to eltrombopag and side effects of eltrombopag therapy in patients with HCV-associated thrombocytopenia. Patients and methods: This prospective study was carried out on 30 patients with chronic HCVassociated thrombocytopenia (<50,000×109/L) thatprecludes the initiation of HCV therapy. Eltrombopag was initiated at a dose of 25 mg once daily; the dose was adjusted with 25 mg increments every 2 weeks to achieve the target platelet count. The primary end point was to achieve stable target platelet count(>100,000×109/L) required to initiate antiviral therapy and any surgical intervention. Results: Treatment response was achieved in 29 (96.7%) patients. This prospective study showed That when the dependent variable was the increased platelet count at second week of treatment while the independent variables are: age, albumin level, gender, platelet count before treatment, AST, and WBC count. The only significant positive predictive factor was the platelet count before treatment. Conclusion:Eltrombopag causes significant elevation of platelet count in patients with HCV related thrombocytopenia, so that Eltrombopag could be used prior to and during treatment with antiviral therapy when thrombocytopenia become confronting problem as well as before surgical interventions.