Objectives: To assess hepatitis C virus (HCV) serostatus, risk factors, and desire for education about HCV among methadone maintenance treatment (MMT) patients. Methods: We surveyed 200 MMT patients and reviewed charts for 276 patients. Results: The self-report HCV seroprevalence was 34%, adjusted to 52%. The chart review HCV seroprevalence was 70%. Most participants had risk factors for contracting or spreading HCV. Conclusions: There is discrepancy in HCV seroprevalence by self-report versus serum test results among MMT patients. Some HCV+ MMT patients engage in high-risk behaviors for HCV transmission and may not disclose HCV+ status. MMT patients want HCV education.