Abstract Background & Aims: The goal of this study was to uncover possible racial-ethnic differences in hepatitis C presentation in an urban hepatitis clinic. Methods: We surveyed the clinic summary cards of patients with antibodies to hepatitis C virus (HCV) seen from 1993 to 2000 for demographic and laboratory data. Results: A total of 1271 HCV patients were categorized into 4 major racial-ethnic groups consisting of 95 Asian, 232 African American, 323 Caucasian, and 621 Latino patients. The latter showed significantly higher serum alanine transaminase (ALT), aspartate transaminase, and bilirubin levels ( P < 0.0001) and lower serum albumin levels ( P < 0.01) compared with all other racial-ethnic groups. Latinos had the lowest rate of hepatitis B coinfection (2.4%) and were significantly less likely to have normal serum ALT levels ( P = 0.0002) compared with other groups. Asian patients were 10 years older than other racial-ethnic groups and were significantly more likely to be coinfected with hepatitis B virus (HBV) ( P = 0.004). Asian patients also had an equal distribution of infected men and women whereas all other groups showed a male predominance. Injection drug use was a negligible cause of hepatitis C in Asian patients, but a prevalent exposure in Caucasian patients of both sexes and in African American and Latino men was seen. Transfusion was more prevalent in Asian and Latino patients. Conclusions: Hepatitis C risk factors, sex distribution, and coinfection with hepatitis B vary by race-ethnicity. Latino patients showed statistically significant biochemical differences in ALT, aspartate transaminase, bilirubin, and albumin levels compared with all other racial-ethnic groups. Further studies are required to determine the possible causes for these biochemical differences.