Hepatitis C virus (HCV) is one of the leading causes of liver disease. Globally it is estimated that 58 million people have chronic HCV infection with an estimated 3.2 million of those being adolescents and children. The virus causes chronic liver disease in 70–85% of persons infected with HCV with associated sequelae such as cirrhosis, liver cancer, and death. While the most common cause of transmission is injection drug use with shared needles, HCV can be transmitted from an infected mother to her fetus. Close follow-up is critical for the HCV-exposed infant, as approximately 5% of exposed infants will become infected. The focus of this chapter is to review hepatitis C in pregnancy and its implications for the neonate.