Screening can detect chronic HCV infection. Antiviral treatment can successfully eradicate viremia, but data on long-term clinical outcomes are lacking. Most antiviral trials evaluated patients with more severe liver disease. Although counseling and appropriate immunizations in patients identified by screening are likely to be beneficial, studies estimating the degree of benefit are not available. Harms from antiviral treatment and work-up (liver biopsy) appear minimal, but other harms (labeling, false-positives, anxiety) are more difficult to measure. There is insufficient evidence to accurately weigh the benefits and risks of screening for HCV in the general population of otherwise healthy, asymptomatic adults. The yield from targeted screening in high-risk patients, particularly intravenous drug users, would be substantially higher.