Background: Activation of macrophages may be tracked in the blood through the biomarker soluble CD163 (sCD163). The purpose of this research is to determine the significance of soluble CD163 in the severity of liver disease in children. Methods: This study was a case control study performed on 128 children divided into cases with chronic hepatitis C (68 cases) and normal control group (60 cases). Patients fulfilling the criteria were evaluated with complete history, clinical examination, and laboratory investigations including ALT, AST and sCD 163 level. Results: This study showed that the serum sCD-163 had a significant role in prediction of the liver problem. The mean sCD-163 for patients with chronic hepatitis C was 17.7±7.2 and for controls was 9.8±1. Conclusions: The present study shows that the serum sCD-163 had a significant role in prediction of liver damage in patients with chronic hepatitis in children.