A seroprevalence survey of antibodies to HCV was carried out among 2788 hemodialysis (HD) patients in a region of central Italy. Anti-HCV seroprevalence was 28.6%. A multivariate analysis of risk factors showed a significant association with time on HD, history of blood transfusion and metropolitan area of residence. Our study clearly showed that HCV infection is common among HD patients and is partially associated with preventable factors.