Hepatitis C is a significant global health burden, with over 170 million cases documented worldwide. It has been associated with various glomerulonephritides, and up to 60% of those with hepatitis C viraemia may go on to develop chronic kidney disease (CKD) of various severities. The prevalence of hepatitis C virus (HCV) in the haemodialysis population varies from 3-45%, and viraemia has been shown to have an adverse impact on morbidity and mortality. Historically, treatment of hepatitis C in CKD has been challenging - in part due to the specific genotype and due to significant side effects from the accumulation of therapeutic agents excreted by the kidneys. Treatment after renal transplantation is difficult as it has been associated with graft dysfunction and acute rejection. Current guidelines recommend that HCV positivity should not preclude kidney transplantation since a survival advantage is seen compared with similar patients who remain on dialysis therapy. Furthermore, there has been a move to increase the donor pool by transplanting HCV positive kidneys into carefully selected recipients. This review will focus on two main areas: the current treatment regimens for HCV after renal transplantation, with the advent of new antivirals, and the considerations for immunosuppression.