High incidence of hepatocellular carcinoma (HCC) is linked to increased chronic HCV infection. Chronic hepatitis (CH), liver cirrhosis (LC), and HCC are now accepted sequelae , especially in chronic Hepatitis C virus infection. In this study the tumor marker, protein induced by vitamin k absence or antagonist II (PIVKA-II) and Alfa fetoprotein (AFP) was estimated in 50 patients with HCV positive (20 patients with HCC, 15 patients with LC, 15 patients hepatitis C virus positive only) and 10 healthy subjects. PIVKA-II level was significantly increased in HCC group compared to other groups and was correlated to tumor size and portal vein thrombosis with a higher sensitivity and specificity than AFP