The advent of direct-acting antivirals (DAAs) has revolutionized the management of patients with hepatitis C virus (HCV), including those with concurrent hepatocellular carcinoma (HCC). Current evidence suggests that DAAs are generally safe and do not increase the risk of recurrence in patients who have achieved a complete response to HCC-directed therapy, where no viable tumor remains. In patients with active (viable) HCC, DAAs can be considered in select cases. For those with early-stage HCC eligible for curative therapy, initiating DAA therapy post-complete response is recommended, as these patients show higher treatment success compared to those with active HCC. Liver transplant (LT) candidates should have their DAA treatment decisions made individually, factoring in patient preferences and organ availability. Though data on DAAs in intermediate- and advanced-stage HCC are limited, treatment may be appropriate in specific instances, depending on overall prognosis and the patient’s response to HCC therapy. In conclusion, DAAs represent a promising option for the management of HCV in patients with concomitant HCC and should be considered on a case-by-case basis.