Background: The Interleukin (IL-20) cytokine subfamily is a major IL-10 cytokine subfamily that is thought to produce a role in the response to hepatic injury. The IL-22 cytokine is the most studied of this family to the inflammatory imbalance of the liver, and it primarily serves bi-role, it is supposed to increase the susceptibility to HCC development. Objective: We aimed to study the relationship between IL-20 serum levels and the clinical parameters of chronic HCV-associated diseases. Patients and Methods: In this case-control study, a total of 3 groups included Chronic hepatitis C, liver cirrhosis, and HCC post HCV patients (15 in every group) compared by a healthy group concerning serum IL-20 assay. Clinical features, laboratory, radiological elements, and CLD scoring were evaluated and compared with IL-20. Results: The April and FIB-4 scoring show a significant difference (p-value < 0.001) between the chronic hepatitis c patients and both the cirrhosis and HCC group, with no significant difference between cirrhosis and HCC groups. There was a significant difference between the three groups regarding the child. Pugh classification (HCC group by 40% as both child B and C, while 20% child A). In both HCC and cirrhosis groups, the IL-20 level is not related significantly to the first presenting symptom. Conclusions: Newly studied cytokines such as IL-20 are easy, cheap ELISA tests that can be useful in assessing the related clinical parameters of chronic liver disease