The factors that contribute to histological progression of liver disease in HCV are still under investigation. The aim of this study is to evaluate the impact of "Body Mass Index" (BMI) as a measure of obesity on the outcome of chronic HCV infection. The present study retrospectively included 30 consecutive patients from the department of hepatology, gastroenterology and infectious disease at Benha university hospitals between June 2003 and April 2004. Patients included 24 ♂ and 6 ♀ with age range from 25-70 years and BMI between 20-36 kg/m2. The patients were grouped into 2 groups not obese and obese (13/30 and 17/30) respectively. Three factors were identified as independently influencing prognosis: age, BMI and serum ALT. The relative risk of developing advanced fibrosis in obese group is 13 folds the non-obese patients. In conclusion despite the limitations of cross sectional studies, the relative risk of fibrosis progression related to BMI in our analysis as well as in the literature is probably indisputable. However, further longitudinal cohort studies are needed to confirm the current consensus.