Hepatocellular carcinoma (HCC) is one of the most common cancers in the world and there is a rising incidence all over the world. A case-control study was done. 214 cases of HCC were enrolled from National Cancer Institute (NCI) and 321 controls enrolled from orthopedic department Kasr El Ainin. All the cases and control were interviewed using a standard questionnaire blood were collected all serum were tested for hepatitis B and C markers. This study found that exposure to pesticides is significantly associated with HCC, This association is masked by living in rural areas which is a more significant risk factor for HCC. Also Hepatitis C and B virus are highly significant associated with HCC.