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Context: Hepatitis C virus (HCV) is both hepatotropic and lymphotropic. Chronic HCV infection has been associated with extrahepatic manifestations, especially lymphoproliferative disorders. Follicular lymphoma (FL) is the most common subtype of indolent non-Hodgkin lymphoma. Objective: To clarify the relationship between HCV and FL, we compared the prevalence of clinicopathologic characteristics between HCV-infected and HCV-non-infected FL patients. Design: A comparative retrospective study included 103 FL patients who presented at our institution during 2008-2018. Setting: It was carried out in the Hematology unit at Oncology Center, Mansoura University (OCMU). Patients: 103 patients with FL who were F/M (47.6/52.4%) with mean age 55.36 ± 11.82 years. The prevalence of HCV infection among FL patients was found to be 49.5%. Interventions: They were treated by rituximab ± anthracycline or alkylator-based regimens. Radiotherapy was the treatment of choice in selected low stage I/II. Main Outcome Measures: The impact of HCV infection on clinicopathological features of FL and its impact on clinical outcome. Results: In this study, HCV-positive FL patients commonly had B symptoms (P = 0.023), stage IV (P = 0.016), high FLIPI score (P =0.042) and absent BCL2 expression (P = 0.041). While no differences were detected regarding gender (P =0.28), grade (P = 0.78) and overall response rate (P = 0.2). PFS was significantly improved with low FLIPI score (P = 0.028), meanwhile, no differences were detected regarding HCV-status (P = 0.27) and grade (P = 0.17). Median OS was not reached. It was significantly improved in Grade 1, 2 (P Conclusion: The prevalence of HCV infection among our studied FL patients is ∼49.5%. HCV infection was significantly associated with more aggressive clinicopatholigical features and shortened OS. Thus, early detection and eradication of HCV infection in FL may improve the outcome.