Infection with hepatitis C virus (HCV) has become the most important public health problem in Egypt. Viral hepatitis and schistosomiasis are the major cause of chronic liver disease among Egyptians. Histological examination of the liver is an integral part of the evaluation of patients with chronic hepatitis C (CHC). Knowledge of the stage of liver fibrosis is essential for prognosis and decisions on antiviral treatment. Liver biopsy is currently the gold standard in assessing liver histology. Although percutaneous liver biopsy is in general a safe procedure, it is costly and does carry a small risk for complication. In addition; there could be sampling error because only 1/ 50,000 of the organ is sampled. Hence, there is a need to develop accurate and reliable noninvasive means to assess the severity of hepatic fibrosis. AST to platelets count ratio index (APRI) was developed to amplify the opposing effects of liver fibrosis and cirrhosis on AST and platelet count. This study was designed to predict significant fibrosis and cirrhosis using APRI-index using routine laboratory data among Egyptian patients with HCV. Using optimized cut-off values, significant fibrosis and cirrhosis could be predicted accurately in 71.4 % and 67.6 % respectively of 210 adult HCV Egyptian patients. Application of this APRI-Index may decrease the need for staging liver biopsy specimens among HCV patients.