In this study, we aimed at detection of caspase 3 activity (one of apoptosis executioners) in patients’sera with chronic HCV and PNALT in comparison to patients with elevated ALT. We aimed also at assessment of histological activity in both groups and its correlation with caspase 3 activity. Results: The majority of patients with PNALT showed evidence of inflammation in liver biopsies (70%) with 23.3% of the patients showing more severe inflammation (≥ A2). Whereas (90%) of chronic HCV patients with elevated ALT showed higher grade of histological activity (≥ A2). The majority of patients (66.6%) with PNALT showed evidence of fibrosis in liver biopsies with 26.6% of patients showing more advanced fibrosis (≥ F2 METAVIR). Only 33.4% of PNALT patients showed no evidence of fibrosis in liver biopsy specimens with only one patient out of them showed evidence of frank cirrhosis (F4).Whereas (80%) of patients with elevated ALT showed significant fibrosis and (30%) showed frank cirrhosis. Conclusion: caspase 3 activity was significantly correlated with serum ALT levels in both patients with PNALT and patients with elevated ALT. No statistically significant relation was found between serum caspase 3 activity and grade of histological activity or stage of fibrosis.