ABSTRACT : Background: Hepatitis C virus (HCV) infection is one of the major causes of chronic hepatitis, cirrhosis, and hepato-cellular carcinoma. The global burden of HCV infection is unknown due to the asymptomatic nature of acute infections. World Health Organization (WHO) estimated in 1999 that 3% of the world's population was chronically infected with HCV. No data is available on the prevalence of HCV in Bahrain. Since 2005 premarital screening for hereditary blood diseases and sexually transmitted diseases is obligatory to all Bahrainis applying for marriage certificate. The objective of this study was to determine the sero-prevalence of HCV, identify the characteristics of positive cases and most common risk factors among candidates attending premarital screening in Bahrain in order to determine if policy changes were required to include HCV as part of premarital testing. Methodology: A cross sectional study involving individuals attending premarital screening in Bahrain during the period of 1st April and 15th May 2006. The inclusion criterion was that one or both of the partners was Bahraini. A single blood sample was collected and analysed for anti-HCV using third-generation enzyme immunoassay (EIAs) and confirmatory immunoblot assays including INNO-LIA and RTPCR. A structured questionnaire was filled by the researcher to identify possible risk factors and behaviors for acquiring HCV infection, through interviewing of positive candidates. Results: The study population was 1070 with Males 546 (51%), Females 524 (49%) The mean age of the sample was 25. 9 ± 7.1 years, ranging between 14 and 74 years. The mean age of the positive HCV cases was 31.5 ± 8.9, median was 24 years ranging between 18 and 43 years. The seroprevalence for HCV antibodies was 1.5%. There was no significant relation between HCV infection and gender, education level, working status, or marital sequence. There was significant relation of HCV infection with age (P=.000) with peak prevalence between 34-43 years. The two main significant risks identified in positive cases were history of surgery (50%) of cases and blood transfusion (25%) of cases. There was significant association between HCV infection and history of surgery (x2 15.047 P=.000), history of blood transfusion (x2 91.738 P=.000), history of STDs (x2 6.065 P. 014), history of substance abuse (x2 50.811 P=.000). Conclusion: The study showed low prevalence of HCV according to WHO classification and the majority of positive cases had history of at least one risk factor that could be identified with careful history during the routine premarital counseling. The rate of HCV seropositivities in this study are similar to those reported by WHO for other GCC countries. These results cannot be extrapolated to the whole population in Bahrain; however, they provide a good reference for future studies and for disease prevention and healthcare planning. It is recommended to improve the current screening procedure relevant to HCV high-risk identification during premarital counselling, and screening those individuals identified as high risk.