Abstract： Direct-acting antivirals (DAAs) can achieve a high cure rates in most patients with hepatitis C, including many previously refractory patients, making it possible to eliminate hepatitis C. The prevalence of hepatitis C in high-risk populations is significantly higher than that in general population. Therefore, the micro elimination strategy of elimination of hepatitis C according to the characteristics of different high-risk groups may be a more practical and feasible way. Currently, the screening of HCV in some high-risk or special populations has been applied in China, such as dialysis patients, pregnant women, and patients with hepatitis B or human immunodeficiency virus infection. However, there are still other high-risk groups of hepatitis C that can’t be identified by the routine screening system due to their scattered distribution, the first diagnosis in the non-infectious department, the lack of understanding of hepatitis C by the medical staff, or belonging to the marginalized group, which have become the blind spots and difficulties in the elimination of hepatitis C. This article discusses the challenges in diagnosis and treatment of these special populations, in order to provide reference for public health workers and clinicians, especially doctors in non-infectious or hepatology departments to better carry out the screening, diagnosis and treatment of hepatitis C in China.