Background: Children with cancer are at a high risk for hepatitis C virus infection due to immunosuppression secondry to chemotherapy and multiple transfusions of blood products during the course of the disease.Aim: The aim of this study is to evaluate the presence of HCV infection in children with malignant diseases, different risk factors, clinical course, laboratory, histopathological findings, natural history and type of response to HCV treatment. Methods: The medical records of 31 patients recruited from the pediatric hepatology clinic at Cairo University pediatric hospital and presenting with post malignant virus C infection were reviewed retrospectively for data of medical history, physical examination and periodic evaluation clinically and laboratory during their follow up. Results: The mean age at diagnosis of HCV infection was 8+3.3 years, the period of follow up of the patients in the hepatology clinic ranged from 0.3 to 15 years with a mean of 2.6+ 2.3 years. Risk factors for HCV acquisition were chemotherapy in 93.5%, blood transfusions in 83.9%, operations in 64.5%. Out of the 31 cases, 51.6% were diagnosed as leukemia. At presentation serum ALT level was elevated in 83.9% and AST level was elevated in 80.6%. Liver biopsy were performed to 26 cases; 96.1% had mild to moderate activity, 32% had no fibrosis and 68% had mild to moderate fibrosis. Eighteen cases received HCV treatment. The response to HCV treatment was 27.7%. Conclusion: Although hepatitis C infection acquired by childhood cancer survivors was presented initially with high rate of elevated liver enzymes and PCR positivity, it seems to have a relatively benign clinical course with mild to moderate chronic hepatitis.