In 2022, hepatitis C virus (HCV) affected around 50 million people globally, leading to 242 000 deaths. This virus, which infects the liver, spreads primarily through contact with infected blood. If untreated, HCV can lead to severe liver damage, including fibrosis, cirrhosis and liver cancer. People who inject drugs (PWID) are at particular risk, with injection drug use identified as a major transmission route. In Belgium, PWID account for approximately 20% of chronic hepatitis C cases. This group, however, faces significant treatment barriers, including substance use and mental health challenges, which often lead to inconsistent treatment adherence and increased risk of reinfection. Such issues have historically made healthcare providers cautious about initiating treatment for PWID. However, the introduction of direct-acting antiviral (DAA) therapy in 2019 has significantly improved treatment success rates. Unlike the previous interferon-based therapy, DAA treatments are highly effective, with fewer side effects and a fast-acting mechanism that reduces the risk of transmission by quickly curing the virus. Despite the high cost—around €50,000 per patient—DAA therapy has shown remarkable success even among high-risk populations. Accessible care centers for PWID emphasize awareness, testing, and specialized services, including harm reduction programs such as needle exchanges and opioid substitution therapies. While maintaining treatment adherence in PWID remains challenging, the study found that both accessible and standard care approaches achieved similar success rates. With intensive guidance and adherence-focused support, PWID can achieve favorable treatment outcomes, demonstrating that effective HCV treatment is feasible even in complex cases. Long-term benefits of this approach include reduced societal costs from fewer repeated treatments and a decline in severe health complications related to untreated hepatitis C. This research underscores the benefits of simplified, accessible hepatitis C care for PWID, tailored to meet their unique needs. By focusing on early intervention, psychological support, and harm reduction, accessible care models can improve patient retention and adherence, contributing to the World Health Organization’s hepatitis C elimination goals.