Background: Serum gamma-glutamyl transferase (GGT) enzyme activity found predominantly in diseases of the liver, biliary tract and pancreas. GGT level could act as predictor to liver fibrosis. Aims: To investigate the relationship between GGT levels and histopathological hepatic assessment in patients with chronic hepatitis C. Materials and Methods: This study included 130 patients suffering from chronic hepatitis C (CHC) infection who referred to Hepatology and Gastroenterology outpatient clinic at Shebin El-Kom Teaching Hospital to be enrolled in the National Committee for Control of Viral Hepatitis (NCCVH) from March to November 2014 before starting antiviral therapy by with peg–interferon/ribavirin (peg–IFN/RBV). All patients were evaluated histopathologically by liver biopsy and GGT level was measured. Results: GGT is elevated in CHC patients (Mean ± SD 68.8±39.6) the upper limit of GGT (up to 30 U/L). While, there was no correlation between GGT levels and quantative PCR assay of HCV RNA. There was a positive correlation between body mass index (BMI) and degree of hepatic steatosis in the studied cases (P value < 0.001). Histopathological assessment of liver biopsy by METAVIR and ISHAK scoring systems revealed highly significant statistical difference between different stages of fibrosis and degrees of hepatic steatosis regarding GGT level (P value < 0.001) with positive correlation between GGT levels and staging of fibrosis, hepatitis activity index (HAI) and degree of steatosis (P value < 0.001.( According to the area under the curve (0.944), GGT was a significant indicator to advanced fibrosis at a cutoff point 63.5 U/L with sensitivity 91.9% & specificity 79.6% in indicating advanced liver fibrosis. Conclusion: GGT levels could be taken into consideration to predict stage of liver fibrosis and degree of hepatic steatosis.