Abstract Background The changes in liver stiffness after receiving (ombitasvir, paritaprevir and ritonavir plus ribavirin) combination therapy for HCV in chronic hepatitis C patients with chronic kidney disease, using transient elastography (fibroscan). Aim of the Work This study aims to assess the changes in liver stiffness after receiving (ombitasvir, paritaprevir and ritonavir plus ribavirin) combination therapy for HCV in chronic hepatitis C patients with chronic kidney disease, using transient elastography (fibroscan). Patients and Methods This study was Prospective cohort clinical study that was conducted at hepatology and virology outpatient clinic at Ain Shams University Hospital from August 2018 to march 2019 after informed consent. 50 patients who directed antiviral drugs (ombitasvir, paritaprevir and ritonavir plus ribavirin) for 12 weeks were included in this study after taking their consent for this clinical trial after full explanation of the trial. The 50 included patients with chronic HCV and chronic renal disease (naïve patients who did not receive any treatment before) and all were treated with quadrable therapy (ombitasvir, paritaprevir and ritonavir plus ribavirin) for 12 weeks. All patients had a Succes rate of 100% Results The present study showed significant reduction in ALT, AST and albumin after receiving DAAs in comparison to their levels before treatment with P value <.001. Conclusion Transient elastography has a diagnostic and prognostic role in patients with HCV and CKD during treatment with DAA. There was insignificant correlation between renal profile and degree of fibrosis by fibroscan.