Scientists and clinicians have made tremendous advances in understanding the pathogenesis of hepatitis C virus (HCV) infection and have developed impressive strategies for treating this hepatotropic virus in the short time since its discovery in 1989. This article goes beyond the current guidelines for the treatment of HCV infection to examine the use of multiple pretreatment factors to predict response; the use of viral kinetics to guide length of treatment; higher dose ribavirin in genotype 1 infection; retreatment of non responders and relapsers; and improving adherence to therapy.