Aim: To assess liver fibrosis in chronic hepatitis C hemodialysis patients by fibroscan and comparing its results with serum hyaluronic acid level. Method: This is cross sectional study was conducted from July 2012 to March 2014 on a cohort of 134 Egyptian patients on chronic hemodialysis patients at Kasr Al Ainy hospital (King Fahd and Kidney & dialysis units) aged between 17 and 67 years for more than one year of hemodialysis. All patients were subjected to routine labs, HBs Ag, HBc Ab, HBe Ag, HCV Ab and HIV Ab, quantitative PCR for both HCV and HBV, hyaluronic acid serum level, alpha feto protein (AFP). Abdominal ultrasound was done to positive cases, 29 patients out of 77 HCV positive patients had a fibroscan done and results are correlated with serum hyaluronic acid level. Results: The mean of age is 47.43 ± 12.65 years, 50.7 % males and 49.3% female, duration range was 1-18 with mean 5.96 ± 4.12 years. The most common cause for ESRD was hypertensive nephropathy 32.1% and diabetic nephropathy 18.7%. HCV +ve 57.5 % and 42.5% -ve, HBV +ve 3%.There was significant correlation between HCV PCR and duration of hemodialysis (p < 0.001), number of blood transfusions (p < 0.001) and hyaluronic acid (p 0.029). There is a significant correlation between serum hyaluronic acid and hemodialysis duration (p 0.003). Also, there is a significant correlation between serum hyaluronic acid and fibroscan (p < 0.001). Conclusion: Fibroscan is a simple noninvasive test that can be used to assess liver fibrosis in hemodialysis patients.