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Hepatitis C virus (HCV) is one of the most common infections among hemodialysis (HD) patients. It continues to be exasperating problem in many HD centers, in spite of strictly following infection and quality control measures.This is a multi-center retrospective comparative study, carried out in different HD units of Menoufia Governorate, Egypt. Patients who were HCV negative on starting HD were divided into two groups; Group-1 included patients who remained negative for HCV and group-2 included patients who seroconverted to HCV positive status during dialysis. Risk factors for seroconversion were compared between the two groups.Out of the 514 surveyed patients, 259 were negative for HCV and 255 were positive; the prevalence of HCV infection was 49.6%. A total of 303 patients who were HCV negative on starting HD were recruited in the study. Group-1 included 259 patients who remained negative for HCV and group-2 included the 44 patients who seroconverted to HCV positive status during dialysis. Patients in group-2 had significantly longer duration on dialysis compared to group-1 (71 .4 versus 33.7 months) and they had stronger family history of HCV infection (20.5% versus 6.4%).There is high prevalence and high seroconversion rate of HCV in surveyed HD units. Following infection control measures and strict supervision of dialysis staff should be emphasized. More studies are needed to evaluate the possible benefits of isolation protocols of HCV patients on regular HD.