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Fetuin A is a hepatokine, which inhibits insulin receptor tyrosine kinase in liver. Aim: To assess fetuin A level in patients with chronic HCV with or without diabetes and whether it is the link between the disease and insulin resistance. A case control study was conducted on eighty subjects. Sixty patients with chronic HCV were divided into two groups thirty patients with and thirty patients without diabetes and twenty normal subjects as control group. Participants were subjected to history, examination and measurement of FBG, Fasting insulin, HOMA-IR, HbA1C, Fetuin A and alfa fetoprotein. Fetuin A was higher in patients with chronic hepatitis C with and without diabetes P<0.001, the highest level in the group with HCV with diabetes.Fetuin A correlates positively with BMI, fasting blood glucose, fasting insulin and HOMA-IR P<0.001. fetuin A may represent an important role in development of insulin resistance in patients with HCV.