Hepatitis C is a major health problem .Global prevalence of chronic hepatitis C is estimated to average 3% (ranging from 0.1 to 5% in different countries). There are 175 million chronic HCV carriers throughout the world. Egypt has the highest countrywide prevalence of HCV in the world with an estimated 8-10 million patients among a population of 68 million, where the seroprevalence was about 30% of the whole population Oxidative stress and enhanced reactive oxygen species production occurring in the liver of patients with chronic hepatitis C initiate a cascade of liver damage leading to active fibrogenesis. This study was done to determine oxidative stress and antioxidant status in Egyptian chronic active hepatitis C patients through measuring serum Malondialdehyde (MDA) level (a product of lipid peroxidation) and measuring serum level of ceruloplasmin.The present study was conducted on 40 of Egyptian chronic active hepatitis C patients from those attending the Tropical Clinic, Kasr-El- Aini Hospitals. They were divided into two groups according to ultrasonography findings. Group I (a), 26 patients of chronic active hepatitis C without cirrhosis, and group I (b), 14 patients of chronic active hepatitis C with cirrhosis. The patients were compared to a control group, group II, of 15 healthy subjects of matching age and sex. All are subjected to full history taking, thorough clinical and ultrasonography examination, routine laboratory investigations (liver function tests). Serum hepatitis markers, MDA and ceruloplasmin were also done.Analysis of serum showed that the mean serum levels of MDA were significantly higher in all CAHC patients (11.63 ± 3.89 ) in CAHC without cirrhosis, ( 9.3 ± 1 ) in CAHC with cirrhosis, compared to controls (8.05 ± 0.8 ) (P <0.01 ), with the highest values observed in CAHC without cirrhosis when compared to CAHC with cirrhosis. Serum MDA was positively correlated with serum ALT (r =0.663; P <0.01) but negatively correlated with serum protein ( r = -0.506; P <0.01) and negatively correlated with serum albumin ( r = -0.633; P<0.01 ). However comparison between group I (a), group I (b) and group II showed no statistically significant differences as regard serum ceruloplasmin.In conclusion, the measurement of lipid peroxidation product e.g. (MDA) can be used for follow up of chronic active hepatitis C infected patients as it is a useful marker for disease activity and for early detection of fibrosis.