Egypt has a high prevalence of hepatitis C virus (HCV) and cardiovascular diseases. The aim of the study was to determine the relation of HCV liver cirrhosis and atherosclerosis and cardiomyopathy .Study included 60 patients compared to 20 normal subjects with same cardiovascular risk profile. All subjected to PCR for measurement of viral load , genotype identification, carotid duplex to measure carotid intima media thickness (IMT) and Echocardiography .Higher (IMT), left atrial dimension (LAD), but lower E/A ventricular were found in HCV patients . Conclusion: There was a possible role of HCV in atherosclerosis, structural and functional heart disease. The risk was higher with non 4a genotype.