This work aimed to study the safety and efficacy of methotrexate among Egyptian RA patients with concomitant HCV infection.Twenty four patients fulfilling the 1988 ACR revised classification criteria for RA were included. Eight of the patients also had concomitant HCV. All the patients were subjected to full history taking, clinical examination, laboratory investigations as well as plain radiograph of hands. Baseline liver biopsy was taken from RA patients with HCV. All patients were then followed up for a 6 month period as regards clinical and laboratory manifestations.No statistical difference was found regarding liver function tests of patients at baseline visit compared to last visit during the study. Also, none of the patients with HCV showed marked liver fibrosis on liver biopsy.