Background: Chronic hepatitis C infection and cirrhosis have slowlyprogressive course and accompanied by liver inflammation and fibrosis.Increased serum neopterin level has been detected in patients havingChronic hepatitis C disease. Neopterin is produced bymonocytes/macrophages when activated by interferon-gamma secreted fromT lymphocytes as a part of body immune response against hepatitis C viralinfection.Objectives: To assess the changes in the serum neopterin level inEgyptian patients having chronic liver disease due to hepatitis C virusinfection and cirrhosis , and to correlate the neopterin levels with changes inthe laboratory parameters and pathological stages of liver disease .Methods : 85 subjects were included; 40 patients having chronic hepatitisC as group I , 30 patients having cirrhosis as group II and a control groupincluded 15 healthy subjects as group III .Results : Serum neopterin level was higher in patients with chronichepatitis C disease and in patients with liver cirrhosis compared to healthyindividuals. Also liver cirrhosis patients had higher serum neopterin levelthan patients with chronic hepatitis C disease.Conclusion : A correlation was found between serum neopterin level andseverity of chronic hepatitis C and cirrhosis as assessed by liver biopsy andChild-Pugh score.