Egypt has possibly the highest Hepatitis C Virus (HCV) prevalence worldwide. A high proportion of HCV infections become chronic and lead to liver cirrhosis and hepatocellular carcinoma (HCC). Although most patients with chronic hepatitis C are asymptomatic, an appreciable number will experience symptoms that are due to the liver disease and /or extrahepatic manifestations of HCV infection. Recognition of these symptoms will lead to early diagnosis and treatment of hepatitis C.Hepatitis C virus (HCV) infection has been reported to be associated with a wide range of immunologic markers and extra hepatic conditions, most notably; essential mixed cryoglobulinemia, membranoproliferative glomerulonephritis , porphyria cutanea tarda and non-Hodgkin`s lymphoma, Other associated conditions, with a wide range of reported frequencies include lichen planus, autoimmune thyroiditis, diabetes mellitus and Sjogren`s syndrome. Early recognition and diagnosis of these manifestations may lead to early diagnosis and successful treatment of chronic hepatitis C infection.