Background:  Infection with hepatitis C virus frequently progresses to cirrhosis and liver cell cancer. Objectives: The objective of this study was testing the usefulness of miR-122 as a marker for diagnosis of cirrhosis in chronic infection with hepatitis C virus (CHC) and as a diagnostic tool for early detection of hepatocellular cancer. Methods: This study included 118 patients; the first group included eighty-eight patients with chronic hepatitis C (CHC) and HCV related cirrhosis, the second group included thirty patients with HCC on to of chronic HCV infection, and the third one included twenty controls. Quantification of the viral RNA by real-time-PCR. MicroRNA-122 expression level was measured by RT-PCR. Results: The mean serum levels of miR‑122 were much higher in CHC, compensated cirrhosis and decompensated cirrhosis patients' than in controls, while they were less in HCC patients than control group (p < /em> = 0.0001). Serum miR-122 revealed gradual decrease in levels with progression of fibrosis stage, with more significant decrease in late fibrosis stages including F3 and F4 (p < /em>=0.01). Conclusion: The mean levels of serum miR-122 decreased in patients of HCC thus can differentiate HCC from CHC and liver cirrhosis. MicroRNA -122 had high efficiency compared to other noninvasive indices in prediction of HCV, and progression towards HCC.