Background:Only few studies have evaluated the epidemiology and risk factors of hepatitis C virus (HCV) infection in Egyptian children with type 1 diabetes mellitus (T1DM). The present study aimed at measurement of the rates of anti‑HCV positivity by Enzyme‑Linked Immuno‑Sorbent Assay (ELISA) test and of HCV‑Ribonucleic acid (RNA) positivity by polymerase chain reaction (PCR) among children with T1DM and to study the possible risk factors of infection. Settings and Design:Cross‑sectional controlled study. Materials and Methods:The study included 150 children with T1DM (Group 1) (mean age 14. 76 ± 6.4 years). Fifty children age and sex‑matched were included as control group (Group 2) (mean age 13.62 ± 2.11 years). They were screened for HCV antibodies using third generation ELISA and HCV‑RNA positivity by PCR. Results: The frequency of anti-HCV positivity by ELISA was significantly higher  in children with T1DM (n = 150) in comparison wiith control group (n = 50) (12% vs 6%;P0.001), while the frequency of HCV‑RNA positivity by PCR among the cases testing positive by ELISA was 75% for both diabetic group and control group. There were no significant differences in serum levels of liver biochemical profile in diabetic children with anti-HCV positivity (n = 18) in comparison to those with anti‑HCV negativity (n = 132). Residence in rural area, low socioeconomic class and prior hospitalization were significant  risk factors for anti‑HCV positivity by ELISA. Conclusions:The frequency of HCV infection in children with T1DM in Upper Egypt appears to be high and is mainly related to residence in rural area, low socioeconomic class and prior hospitalization. HCV infection in these children is not associated with significant changes in hepatic biochemical parameters. Recommendations:Implementation of strict infection control measures are highly recommended to reduce the frequency of HCV infection. Furthermore, the silent evolution of HCV infection in children makes periodic screening of HCV in diabetic children mandatory.