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Background: Hodgkin's lymphoma (HL) (formerly, Hodgkin disease) is a potentially curable lymphoma with distinct histology, biologic behavior, and clinical characteristics. The disease is defined in terms of its microscopic appearance (histology) and the expression of cell surface markers (immunophenotype). Objective: In this study we aim to evaluate the serum level of IGF-1 as prognostic factor in patients with Hodgkin lymphoma and its impact in outcome of treatment. Patients and methods: This study was conducted in the Internal Medicine Department of Al-Azhar University, during the period from January 2018 to December 2018. It was carried on 60 patients diagnosed with HL. All patients had a confirmed histopathological examination as HL before inclusion in the study. Patients were classified into (3 equal groups) according to (Ann Arbor staging classification scheme): Group -1: 20 patients with HL in stage I &II. Group -2: 20 patients with HL in stage III. Group -3: 20 patients with HL in stage IV. An approval of the study was obtained from Al-Azhar University academic and ethical committee. Every patient signed an informed written consent for acceptance of the operation. Results: In our study, patients with HL had significantly higher levels of IGF-1 in advanced stages than limited stages. Since serum levels of IGF-1 is a potent proliferative agent affecting almost every cell type and a powerful antiapoptotic agent affecting apoptotic responses to a variety of agents of numerous cell types. These two effects result in a state of hyperproliferation. Such an imbalance between cell proliferation and death. Also, our study showed the higher level of IGF-1, the good response to aggressive chemotherapy. Conclusion: IGF-1 may be a prognostic factor in HL and may be useful for the identification of a subgroup of patients who may benefit from aggressive chemotherapy. [ABSTRACT FROM AUTHOR]