Objective: To investigate the prevalence of hepatitis C in Tianjin, China and major risk factors, and to provide a theoretical basis for the development of scientific prevention and control strategies for hepatitis C. Methods: The monitoring system of notifiable infectious diseases was used to establish the database of hepatitis C cases reported from 2004 to 2014 in Tianjin. With reference to the results of serological surveillance and special case-control investigation, a statistical analysis was performed to investigate the epidemiological characteristics and prevalence of hepatitis C in Tianjin, as well as related risk factors. Results: The report rate of hepatitis C in Tianjin showed a decreasing trend from 2004 to 2014(χ 2 = 150.018, P < 0.01). The group aged 60 years had the highest report rate(9.09/100000), and there were significant differences between this group and other groups(χ 2 = 2540.887, P < 0.01). The six urban districts in Tianjin had the highest report rate(6.54/100000), and there were significant differences between this area and other areas. The multivariate logistic regression analysis showed that a history of surgery(χ 2 = 12.57, P < 0.01), blood transfusion and blood products(χ 2 = 36.67, P < 0.01), hemodialysis(χ 2 = 4.62, P < 0.01), and intravenous drug use(χ 2 = 12.92, P < 0.01)were major risk factors for hepatitis C. Conclusion: The epidemic situation of hepatitis C in Tianjin tends to decrease in recent years. Although there is no effective vaccine for hepatitis C, it still can be prevented and treated. The most effective interventions for hepatitis C include strengthening health education and raising the awareness rate of hepatitis C in the whole population, as well as early detection, diagnosis, and treatment.