The Egyptian Demographic Health Survey (EDHS), which was carried out in 2008, determined that Egypt has the highest HCV prevalence in the world. Individuals who suffer from chronic hepatitis C (CHC) are very susceptible to potentially fatal outcomes, including cirrhosis and hepatocellular carcinoma (HCC). Liquid biopsies, or the collection and examination of non-solid biological tissue such as blood, are a less intrusive diagnostic approach that may help with early tumor diagnosis. The methylation characteristics of tumor suppressor genes in DNA have been investigated as possible biomarkers for various forms of cancer for the past two decades. In that period, research has discovered that tumors are characterized by global DNA hypomethylation and localized hypermethylation, which frequently affects the promoter region of tumor suppressor genes. Ras Association Domain family 1A (RASSF1A) is one of the most well-known and studied biomarkers in liquid biopsies. Hypermethylation was associated with loss of RASSF1A expression. Patients and methods: To evaluate the RASSF1A gene methylation percentage in patients with different liver disease stages, we collected fresh whole blood samples from 29 healthy subjects as control, 30 non-cirrhotic HCV patients, and 30 cirrhotic HCV patients. Demographic and clinical parameters were recorded, and the methylation status of the RASSF1A gene was detected using methylation sensitive restriction enzyme-quantitative polymerase chain reaction (MSRE- qPCR). Results: The obtained results showed a significant RASSF1A promoter hypermethylation in non-cirrhotic HCV and cirrhotic HCV 31.0%, and 33.3% respectively, and got an overall predictive value of 75.3% to predict the incidence of cirrhotic HCV. Conclusion: Detection of methylated RASSF1A status could be a valuable early diagnostic marker of Cirrhotic HCV patients.