Hepatitis C virus (HCV) is known to be associated with many rheumatic autoimmune manifestations including arthritis that may mimic Rheumatoid Arthritis (RA). This work aimed to study the prevalence of HCV infection among Rheumatoid Arthritis (RA) patients and to compare RA patients with and without HCV infection as regards pattern of disease, disease activity, functional assessment and radiological damage. Patients and methods: 110 patients (88.2% females and 11.8% males) fulfilling the 1987 ACR revised classification criteria for RA were included. They had mean disease duration of 7.92± 6.56 years. All patients were subjected to full history taking and clinical examination. Routine laboratory investigations, anti-cyclic citrullinated peptides (anti-CCP) and testing for HCV-antibody (HCV-Ab) were done. Quantitative polymerase chain reaction (PCR) was used for detection of viremia in HCV-Ab positive RA patients. Plain radiographs of hands & feet were done for all patients. HCV-Ab was detected in 22 patients (20%). Active viremia was detected in 14 RA patients (12.7%). No differences were found between HCV-Ab positive and - negative RA patients as regards disease activity and radiological damage, however, HCV-Ab positive patients had longer RA disease duration, more joint deformities and functional disability than HCV-Ab negative RA patients. They also had a higher frequency of hepatomegaly, vasculitis and bronchial asthma. The prevalence of HCV infection is 20% among Egyptian RA patients. Most patients with active viremia have normal liver enzymes, indicating the necessity for routine screening of RA patients for HCV infection in Egypt. Although the presence of HCV infection has no impact on the disease activity or severity of RA, it is associated with significant comorbidities in the form of hepatomegaly, vasculitis and bronchial asthma.