Background: HCV infection is considered a major health issue in Egypt. Dual therapy of sofosbuvir and ribavirin is now available for treatment of HCV but has not widely used in the treatment of cirrhotic patients. Objectives: This study aims to evaluate the efficacy and safety of combined therapy of sofosbuvir with ribavirin as a treatment for chronic hepatitis C (CHC) patients genotype 4 with cirrhosis. Methodology: sixty chronic HCV patients with liver cirrhosis were evaluated (clinically, laboratory, sonoraphically, upper GI endoscopy and liver biopsy) before treatment then they were treated with sofosbuvir and Ribavirin for 6 months and followed-up by laboratory investigations every month during, at the end of treatment and 3 months after cessation of treatment to determine its efficacy and side effects. Results: SVR rate was 80%, non-responders rate was 1.7% and relapses rate was 18.3%. Conclusion: Dual therapy including sofosbuvir and ribavirin is an effective well tolerated choice for treating CHC patients (genotype 4) with liver cirrhosis.