Background and study aim: Hepatitis C virus infection is a multisystemic disease with many extrahepatic manifestations. Affection of bone matrix density is a common complication of chronic hepatitis and cirrhosis. The pathogenesis of osteoporosis in chronic liver disease is still unknown and is expected to be multifactorial. The aim of this work is to assess the frequency of osteoporosis/osteopenia in patients with chronic hepatitis C virus infection with or without cirrhosis. Patients and Methods: This study was carried out on 30 patients with chronic HCV infection without cirrhosis (Group II), 30 patients with chronic HCV infection with compensated cirrhosis (Group III) and 20 age and gender matched healthy controls (Group I). All subjects of the study performed liver function tests, viral markers, liver biopsy, hormonal assay and Bone Mineral density measurement (BMD) by Dual energy Xray absorptiometry (DEXA). Results: In patients with chronic hepatitis C (group II) the frequency of osteopenia was 11 (36.7%), osteoporosis 2 (6.7 %), total patients with low BMD was 13 (43.3%). In cirrhotic patients (group III), the frequency of osteopenia was 13 (43.3%), osteoporosis was 3 (10.0%), and total patients with low BMD was 16(53.3%) vs 1(5.0%) in the control group (group I). there was also no significant difference between patients with low BMD and patients with normal BMD as regards age, gender, common risk factors, liver function tests or hormonal levels. Conclusion: Reduced BMD is common chronic HCV-infected patients with and without cirrhosis. HCV infection is a risk factor of osteoporosis.