Background Hepatitis C virus (HCV) infection is the most challenging public health problem in Egypt where the prevalence is the highest in the world. Intrafamilial transmission of hepatitis C occurring between patients infected with HCV and their household members sharing the same house and living conditions. Preventive measures of hepatitis C are considered the first line of defense against HCV infection. Aim assess the intrafamilial transmission risk factors and preventive measures followed by household contacts of hepatitis C patients. Design A descriptive cross sectional research design was utilized. Setting The study was conducted at outpatient clinics of Liver Institute at Kafer-Elsheikh Governorate. Sample A simple random sample of 365 household contacts of hepatitis C patients was recruited for the current study. Tool Data was collected through one tool: A structured Interviewing Questionnaire for household contacts of hepatitis C patients which included three parts; part I-(a) Demographic data, (b) Medical history of household contacts, Part II (a) Household contacts knowledge about HCV (b) Hepatitis C risk factors, Part III: Preventive measures followed by household contact of hepatitis C patient: This part is self-reported practices. Results The study revealed that;56.7% of household contacts were males, 72.1% of them were living in rural areas, 75.60% were married, with a mean age ±SD 36.73±9.18 years old.44.1% obtained secondary education, 30.7% were employees, among this group hypertension and diabetes were the main chronic illness. 49.90% had moderate level of general knowledge about HCV infection, 71.50% had low level of knowledge about hepatitis C risk factors and 90.00% had a low level of preventive measures (self-reported practices) regarding HCV. There was no correlation between household contacts knowledge about HCV risk factors and their preventive measures(r=0.031 and P=0.549). Conclusion Almost half of household contacts mentioned that they knew intrafamilial risk factors while about half of this group have a misconception about intrafamilial risk factors, while majority of them stated that they knew sharing scissors and clippers as the main intrafamilial risk factors and less than one-fourth of them knew direct contact with infected blood and sharing of special equitoothbrushesth brushes. Household contacts applied some preventive measures such as; Cover the wound with a piece of cloth or gauze, disinfect the site with alcohol or antiseptic solution and frequent and proper hand washing. Recommendations Routine health assessment of household contacts knowledge regarding intrafamilial risk factors and preventive measures therefore health education sessions should be conducted to raise their awareness regarding HCV infection and further research should be conducted on larger samples of contacts.